No

Immune Globulin

Part of postexposure prophylaxis of persons with rabies exposure who lack a history of pre-exposure or postexposure prophylaxis with rabies vaccine or a recently documented neutralizing antibody response to previous rabies vaccination; although it is preferable to administer RIG with the first dose of vaccine, it can be given up to 8 days after vaccination

C

Inadvertent I.V. administration; allergy to thimerosal or any component

Use with caution in individuals with thrombocytopenia, bleeding disorders, or prior allergic reactions to immune globulins

1% to 10%:

Central nervous system: Fever (mild)

Local: Soreness at injection site

<1%: Urticaria, angioedema, stiffness, soreness of muscles, anaphylactic shock

Decreased effect: Live virus vaccines (eg, MMR, rabies) may have delayed or diminished antibody response with immune globulin administration; should not be administered within 3 months unless antibody titers dictate as appropriate

Refrigerate

Rabies immune globulin is a solution of globulins dried from the plasma or serum of selected adult human donors who have been immunized with rabies vaccine and have developed high titers of rabies antibody. It generally contains 10% to 18% of protein of which not less than 80% is monomeric immunoglobulin G.

Children and Adults: I.M.: 20 units/kg in a single dose (RIG should always be administered as part of rabies vaccine (HDCV)) regimen (as soon as possible after the first dose of vaccine, up to 8 days); infiltrate 1/2 of the dose locally around the wound; administer the remainder I.M.

Intramuscular injection only; severe adverse reactions can occur if patient receives RIG I.V.; injection should be made into the deltoid muscle or anterolateral aspect of the thigh

No information available to require special precautions

No effects or complications reported

Severe adverse reactions can occur if patient receives RIG I.V.

Injection: 150 units/mL (2 mL, 10 mL)

"A New Rabies Vaccine," Med Lett Drugs Ther, 1998, 40(1029):64-5.

Dreesen DW and Hanlon CA, "Current Recommendations for the Prophylaxis and Treatment of Rabies," Drugs, 1998, 56(5):801-9.

Lang J and Plotkin SA, "Rabies Risk and Immunoprophylaxis in Children," Adv Pediatr Infect Dis, 1997, 13:219-55.

Strady A, Lang J, Lienard M, et al, "Antibody Persistence Following Pre-exposure Regimens of Cell-Culture Rabies Vaccines: 10-Year Follow-up and Proposal for a New Booster Policy," J Infect Dis, 1998, 177(5):1290-5.