Adult Dosing
Post-exposure prophylaxis
Not previously vaccinated
- Wound cleansing
- Clean the wounds with soap and water or use a virucidal agent (povidone-iodine solution) to irrigate the wounds
- Rabies immune globulin (RIG)
- Administer 20 IU/kg (0.133 mL/kg) body weight IM
- Infiltrate the full dose around the wound(s) and administer any remaining volume IM at an anatomical site distant from vaccine administration
- Do not administer RIG in the same syringe as vaccine. Doses greater than recommended should not be given, as RIG may suppress (partially) active antibody production
- vaccine
- Human diploid cell vaccine (HDCV), purified chick embryo cell vaccine (PCEC), or rabies vaccine adsorbed (RVA) 1 mL IM (deltoid muscle) on days 0, 3, 7, 14 and 28
Previously vaccinated
- Wound cleansing
- Clean the wounds with soap and water or a virucidal agent (povidone-iodine solution) to irrigate the wounds
- Rabies immune globulin (RIG)
- Vaccine
- HDCV, PCEC, or RVA 1 mL IM (deltoid area) on days 0 and 3
Notes:- The recommended dose must be preferably given at the time of the first vaccine dose; this may also be administered within 7 days after the 1st vaccine dose
- Administer the vaccine only in the deltoid area
- Do not administer vaccine in the gluteal area
- Day the first dose of vaccine is administered should be counted as day 0
Pediatric Dosing
Post-exposure prophylaxis
Not previously vaccinated
- Wound cleansing
- Clean the wounds with soap and water or use a virucidal agent (povidone-iodine) to irrigate the wounds
- Rabies immune globulin (RIG)
- Administer 20 IU/kg (0.133 mL/kg) body weight IM
- Infiltrate the full dose around the wound(s) and administer any remaining volume IM at an anatomical site distant from vaccine administration
- Do not administer RIG in the same syringe as vaccine. Doses greater than recommended should not be given, as RIG may suppress (partially) active antibody production
- vaccine
- Human diploid cell vaccine (HDCV), purified chick embryo cell vaccine (PCEC), or rabies vaccine adsorbed (RVA) 1 mL IM (deltoid muscle) on days 0, 3, 7, 14 and 28
Previously vaccinated
- Wound cleansing
- Clean the wounds with soap and water or a virucidal agent (povidone-iodine) to irrigate the wounds
- Rabies immune globulin (RIG)
- Vaccine
- HDCV, PCEC, or RVA 1 mL IM (deltoid muscle) on days 0 and 3
Notes:- The recommended dose must be preferably given at the time of the first vaccine dose; this may also be administered within 7 days after the 1st vaccine dose
- Administer the vaccine only in deltoid area for older children; the outer aspect of the thigh may be used for younger children
- Do not administer vaccine in the gluteal area
- Day the first dose of vaccine is administered should be counted as day 0
[Outline]
- Rabies immune globulin human is prepared from human plasma; hence, there is an increased risk of transmission of viral infections and theoretically, the Creutzfeldt-Jakob disease (CJD) agent that can cause disease. However, this risk has been reduced by screening plasma donors for prior exposure to certain viruses, and by inactivating and/or removing certain viruses
- Signs and symptoms of certain viral infections, particularly hepatitis C may develop in individuals who receive infusions of blood or plasma products
- Before administering this product, the physician should discuss the risks and benefits of this product with the patient
- In individuals with isolated immunoglobulin A (IgA) deficiency, the physician must weigh the benefits of immunization against the potential risks of hypersensitivity reactions
- Therapy may cause bleeding complications in patients with thrombocytopenia or other bleeding disorders
- Do not administer intravenously because of the potential for serious reactions
Caution: Use cautiously in
- History of hypersensitivity to human immunoglobulin preparations
US Trade Name(s)
- HyperRAB S/D
- Imogam Rabies-HT
US Availability
HyperRAB S/D
- INJ: 150 IU/mL (2, 10 mL vials)
Imogam Rabies-HT
- INJ: 150 IU/mL (2, 10 mL vials)
Canadian Trade Name(s)
- Hyperrab S/D
- Imogam Rabies Pasteurized
Canadian Availability
Hyperrab S/D
- INJ: 150 IU/mL (2, 10 mL vials)
Imogam Rabies Pasteurized
- INJ: 150 IU/mL (2, 10 mL vials)
UK Trade Name(s)
UK Availability
Rabies immune globulin human (generic)
- INJ: 150 IU/mL (500 IU vial)
Australian Trade Name(s)
- Imogam Rabies (Pasteurized)
Australian Availability
Imogam Rabies (Pasteurized)
- INJ: 150 IU/mL (2, 10 mL vials)
[Outline]