Adult Dosing

Immunization

Pre-exposure

• 1 mL IM x3 (given in deltoid) on days 0, 7, and 21 or 28, then may give booster doses based on exposure risk
• A booster dose may be given as needed in persons working with live rabies virus in research laboratories and in vaccine production facilities. Rabies antibody titers should be checked every 6 months
• Laboratory workers, such as those doing rabies diagnostic tests, spelunkers, veterinarians, and animal control and wildlife officers in areas where rabies is epizootic should have boosters every 2 yr or have their serum tested for rabies antibody every 2 yr
• Persons who experience "immune complex-like" hypersensitivity reactions should not receive further doses of the vaccine unless they are exposed to rabies or they are truly likely to be inapparently and/or unavoidably exposed to rabies virus and have unsatisfactory antibody titers

Post-exposure

• Not previously immunized immunocompromised patients
• 1 mL IM x5 (given in deltoid) on days 0, 3, 7, 14 and 28
• Begin series as soon as possible after exposure
• Give concurrent rabies immune globulin on day 0
• Defer immunosuppressant therapy during vaccination series unless essential for other medical conditions

• Patients previously immunized
• 1 mL IM X2 (given in deltoid) on days 0 and 3
• Begin series as soon as possible after exposure

• Not previously immunized immunocompetent patients
• 1 mL IM x4 (given in deltoid) on days 0, 3, 7 and 14 days
• Begin series as soon as possible after exposure
• Give concurrent rabies immune globulin on day 0

Pediatric Dosing

Immunization

Pre-exposure

• 1 mL IM x3 (given in deltoid) on days 0, 7, and 21 or 28, then may give booster doses based on exposure risk
• A booster dose may be given as needed in persons working with live rabies virus in research laboratories and in vaccine production facilities. Rabies antibody titers should be checked every 6 months
• Persons who experience "immune complex-like" hypersensitivity reactions should not receive further doses of the vaccine unless they are exposed to rabies or they are truly likely to be inapparently and/or unavoidably exposed to rabies virus and have unsatisfactory antibody titers

Post-exposure

• Not previously immunized immunocompromised patients
• 1 mL IM x5 (given in deltoid) on days 0, 3, 7, 14 and 28
• Begin series as soon as possible after exposure
• Give concurrent rabies immune globulin on day 0
• Defer immunosuppressant therapy during vaccination series unless essential for other medical conditions

• Patients previously immunized
• 1 mL IM X2 (given in deltoid) on days 0 and 3
• Begin series as soon as possible after exposure

• Not previously immunized immunocompetent patients
• 1 mL IM x4 (given in deltoid) on days 0, 3, 7 and 14 days
• Begin series as soon as possible after exposure
• Give concurrent rabies immune globulin on day 0

• Preexposure vaccination, in both primary series and booster dose
• Postexposure prophylaxis against rabies in all age groups

• Hypersensitivity to any of the ingredients of the product (pre-exposure prophylaxis)
• Acute febrile illness (pre-exposure prophylaxis)
• Intradermal/SC administration

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Anaphylaxis, encephalitis including death, meningitis, neuroparalytic events such as encephalitis, transient paralysis, Guillain-Barre Syndrome, myelitis, retrobulbar neuritis and multiple sclerosis has occurred with use of this vaccine. Carefully consider a patient's risk of developing rabies before deciding to discontinue immunization
• Avoid using by subcutaneous or intradermal route
• Deltoid area is the preferred site of immunization for adults. Administration into the anterolateral zone of the thigh is preferred for small children and infants. Avoid using use of the gluteal region as administration in this area results in lower neutralizing antibody titers
• Avoid injecting intravascularly
• Systemic reactions, including shock have occurred on unintentional intravascular injection. Take immediate measures including catecholamines, volume replacement, high doses of corticosteroids, and oxygen
• Occurrence of active immunity after vaccination is impaired in immune-compromised individuals
• Take utmost care for the safe and effective use of the product. Ask patient's/caregivers about the current health status of the vaccine and reactions to a previous dose of this or a similar product
• Postpone preexposure vaccination in the case of sick and convalescent individuals, and those considered to be in the incubation stage of an infectious disease
• Use a separate, sterile syringe and needle or a sterile disposable unit for each patient to prevent transmission of hepatitis and other infectious agents from person to person
• Avoid recapping of needles and properly dispose them
• Consider possibility of hypersensitivity reactions in individuals hypersensitive to processed bovine gelatin and trace amounts of chicken protein, neomycin, chlortetracycline and amphotericin B
• Administer antihistamines in individuals having history of hypersensitivity is given rabies vaccine. Keep ready epinephrine (1:1000), volume replacement, corticosteroids and oxygen to counteract anaphylactic reactions

Cautions: Use cautiously in:

• Hypersensitivity to any of the ingredients of the product
• Hypersensitivity to albumin
• Hypersensitivity to bovine proteins
• Hypersensitivity to chicken proteins
• Hypersensitivity to neomycin
• Hypersensitivity to chlortetracycline
• Hypersensitivity to amphotericin B
• Concurrent immunosuppressants
• Immunosuppressed

Pregnancy Category:C

Breastfeeding: The centers for disease control and prevention and several health professional organizations informs that vaccines given to a nursing mother does not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to rabies vaccine. Vaccinate breastfed infants according to the routine recommended schedules. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 February 2011). Unknown whether this vaccine is excreted in human milk. Although there are no literatures available, because of the potential consequences of inadequately treated rabies exposure, nursing is not considered a contraindication to postexposure prophylaxis. On substantial risk of exposure to rabies preexposure vaccination might be indicated during nursing.

• HYPERSENSITIVITY: Anaphylaxis, Type III hypersensitivity-like reactions, bronchospasm, urticaria, pruritis, edema
• CNS: Neuroparalysis, encephalitis, meningitis, transient paralysis, Guillain-Barre Syndrome, myelitis, retrobulbar neuritis, multiple sclerosis, vertigo, headache, asthenia, malaise, dizziness
• EENT: Visual disturbance
• CV: Palpitations, hot flush
• LOCAL: Extensive swelling of limb
• GI: Nausea
• HEMA: Lymphadenopathy
• MUSC: Myalgia, arthralgia
• DERM: Rash
• MISC: Death, circulatory reactions, fatigue, fever

• Vaccine, viral; precise mechanism of action unknown; induces neutralizing antibodies and cellular immunity
• Metabolism: Unknown; CYP450: Unknown
• Excretion: Unknown
• Half-life: Unknown

US Trade Name(s)

• Imovax Rabies
• RabAvert

US Availability

Imovax Rabies

• PWDR for INJ: 2.5 International Units of rabies antigen (Human Diploid Cell)

RabAvert

• PWDR for INJ: 2.5 International Units of rabies antigen (Purified Chick Embryo Cell Culture )

Canadian Trade Name(s)

• Immovax Rabies
• RabAvert

Canadian Availability

Immovax Rabies

• PWDR for INJ: 2.5 International Units of rabies antigen (Human Diploid Cell)

RabAvert

• PWDR for INJ: 2.5 International Units of rabies antigen (Purified Chick Embryo Cell Culture )

UK Trade Name(s)

• Rabipur

UK Availability

rabies vaccine (generic)

• PWDR for INJ: 2.5 International Units of rabies antigen (Human Diploid Cell)

Rabipur

• PWDR for INJ: 2.5 International Units of rabies antigen (Purified Chick Embryo Cell Culture )

Australian Trade Name(s)

• Rabipur

Australian Availability

rabies vaccine (generic)

• PWDR for INJ: 2.5 IU/mL (Human Diploid Cell)

Rabipur

• PWDR for INJ: 2.5 IU/ML (Purified Chick Embryo Cell Culture )

Allergy & Immunology

Vaccines

Viral

Infectious Disease

Vaccines

Viral

Pricing data from www.DrugStore.com in U.S.A.

• RabAvert SUSR [Vial] (NOVARTIS VACCINES & DIAGNOSTIC)
  1 = $275.98
  2 = $529.94

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.