The manufacturer (Searle) has no incentive to seek FDA approval, as the drug is not expensive and does not offer great profit, and is used anyway despite lack of such an approval. Another company has been trying to create a misoprostol insert that would pass FDA. If it does, it will cost hundreds of dollars instead of the pennies that generic cytotec costs, without any improvement.

That is a really great site, thanks for pointing it out. I’m going to tweet that out.

Times how many doses? Have you seen http://misoprostol.org/File/guidelines.php ? Good stuff.

“And don’t forget this is also a preferred route if prior uterine incision.”
Lets get a source on that one. With a single uterine incision the rupture rate is about 0.4% (0 in some large series), while complication rates for D and E are above that even in skilled hands. Rates of perforation probably go up with prior scars as well. There’s also the issue of the mother wanting to see the fetus intact. I’m comfortable going either way, as should be most people.