Contents

Search

human diploid cell rabies vaccine (Imovax, Imovax ID, HDCV)

Indications: - rabies exposure or rabies virus exposure Contraindications: (& cautions) 1) developing febrile illnesses 2) allergy to neomycin, gentamicin or amphotericin B 3) caution: administer IM only pregnancy-category C safety in lactation ? Dosage: Post-exposure prophylaxis: - 1.0 mL IM on days 1 & 3 post animal bite in a victim previously immunized or on days 1, 3, 7, 14 following rabies immune globulin (RIG) in an unvaccinated victim. - Alternatively, rabies vaccine adsorbed (RVA) may be used. Pre-exposure prophylaxis: - A series of 3 injections is given 0.1 mL intradermally in deltoids on days 0, 7 & 28, or - A series of 3 doses given 1 mL IM in deltoid on days 0, 7 & 21 or 28. - Booster doses can be given every 2 years Injection: - 2.5 units of rabies antigen/mL (single dose with diluent) Pharmacokinetics: 1) after IM administration, antibody appears in the serum within 7-10 days & persists for at least 1 year 2) elimination: liver Monitor: - antibody-response to vaccine in immunocompromised patients, i.e. formation of rabies immune globulin Adverse effects: - common (> 10%) - swelling, erythema, itching, pain, local discomfort, nausea, headache, abdominal pain, muscle aches, dizziness, malaise, neuroparalytic reactions, hypersensitivity reactions Drug interactions: 1) rabies immune globulin 2) chloroquine: decreased titer of antibody 3) immunosuppressive agents: decreased response to vaccine 4) corticosteroids Mechanism of action: - stimulates active immunity to rabies by promoting production of rabies antibody

Related

rabies immune globulin (RIG, Hyperab Imogam) rabies vaccine adsorbed (RVA, RabAvert) rabies virus

General

Rabies Vaccine

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 - not on National VA formulary
  4. Rupprecht CE et al Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices MMWR March 19, 2010 / 59(02);1-9 PMID: 20300058 http://cdc.gov/mmwr/preview/mmwrhtml/rr5902a1.htm corresponding NGC guideline withdrawn Jan 2016