Contents

Search

rabies immune globulin (RIG, Hyperab Imogam)

Indications: - passive immunity to rabies for postexposure prophylaxis Contraindications: (& cautions) 1) IV administration is contraindicated 2) RIG should not be used in a vaccinated individual with documented antibody response 3) use with caution in patients with thrombocytopenia, bleeding disorders or prior allergic reactions to immune globulins pregnancy-category C safety in lactation ? Dosage: 1) 20 IU/kg 1/2 into infected wound; the other 1/2 IM (gluteal) 2) post-exposure rabies prophylaxis also includes rabies vaccine - RVA or HDCV on days 1, 3, 7, 14 & 28 following animal bite in an unvaccinated victim 3) RIG should be given within 24 hours of exposure Injection: 150 units/mL (vials 2 mL, 10 mL) Pharmacokinetics: 1) following IM administration, antibodies appear in the serum within 24 hours 2) elimination: liver 3) 1/2life is 24 days Adverse effects: 1) most common (1-10%) - soreness at injection site (may last up to 3 days), fever (mild) 2) uncommon (< 1%) - urticaria, angioedema, muscle soreness, anaphylactic shock Drug interactions: 1) immunosuppressive agents may interfere with active antibody response 2) live virus vaccines: RIG may interfere with immune response to some live viruses Mechanism of action: - passive immunity by neutralizing rabies virus so that spread of the virus is retarded

Related

human diploid cell rabies vaccine (Imovax, Imovax ID, HDCV) rabies vaccine adsorbed (RVA, RabAvert) rabies virus

General

immune globulin (Gamastan, Gamimune N, Gammagard, Gammar, Sandoglobulin, Venoglobulin-I, Venoglobulin-S, ISG, Vivaglobulin, Gamunex, Privigen, Gammaplex, Flebogamma, Gammaked, Bivigam, Carimune, Hizentra)

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1171
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998