Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 150 IU/mL (2mL and 10mL vials) (HyperRAB S/D, Imogam Rabies HT, KenRab)
- 300 IU/mL (1mL, 3mL, and 5mL vials) (HyperRAB)
Rabies, Postexposure Prophylaxis
Indicated for passive, transient postexposure prophylaxis of rabies infection, when administered immediately after contact with a rabid or possibly rabid animal
20 International Units/kg, infiltrate locally around bite
Inject any remaining volume IM into the upper arm deltoid region or, in small children, into the anterolateral aspect of the thigh
If bite site is unknown or indeterminate, or difficult to administer (eg, lips, fingers, knees); administer RIG at site(s) distant from the site of the rabies vaccine
Dosage Forms & Strengths
injectable solution
- 150 IU/mL (2mL and 10mL vials) (HyperRAB S/D, Imogam Rabies HT, KenRab)
- 300 IU/mL (1mL, 3mL, and 5mL vials) (HyperRAB)
Rabies, Postexposure Prophylaxis
Indicated for passive, transient postexposure prophylaxis of rabies infection, when administered immediately after contact with a rabid or possibly rabid animal
20 International Units/kg, infiltrate locally around bite
Inject any remaining volume IM into the upper arm deltoid region or, in small children, into the anterolateral aspect of the thigh
If bite site is unknown or indeterminate, or difficult to administer (eg, lips, fingers, knees); administer RIG at site(s) distant from the site of the rabies vaccine
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (6)
- axicabtagene ciloleucel
rabies immune globulin, human (RIG), axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- brexucabtagene autoleucel
rabies immune globulin, human (RIG), brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- ciltacabtagene autoleucel
rabies immune globulin, human (RIG), ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- idecabtagene vicleucel
rabies immune globulin, human (RIG), idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- lisocabtagene maraleucel
rabies immune globulin, human (RIG), lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- tisagenlecleucel
rabies immune globulin, human (RIG), tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
Monitor Closely (12)
- BCG vaccine live
rabies immune globulin, human (RIG) decreases effects of BCG vaccine live by Other (see comment). Use Caution/Monitor. Comment: High dose rabies immunoglobulin may impair response to active immunization.
- efgartigimod alfa
efgartigimod alfa will decrease the level or effect of rabies immune globulin, human (RIG) by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.
- efgartigimod/hyaluronidase SC
efgartigimod/hyaluronidase SC will decrease the level or effect of rabies immune globulin, human (RIG) by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.
- measles (rubeola) vaccine
rabies immune globulin, human (RIG) decreases effects of measles (rubeola) vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
- measles mumps and rubella vaccine, live
rabies immune globulin, human (RIG) decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
- measles, mumps, rubella and varicella vaccine, live
rabies immune globulin, human (RIG) decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
- rabies vaccine
rabies immune globulin, human (RIG) decreases effects of rabies vaccine by Other (see comment). Use Caution/Monitor. Comment: RIG may be administered concurrently with and up to 8 days after rabies vaccine. High dose rabies immunoglobulin may impair response to active immunization. .
- rabies vaccine chick embryo cell derived
rabies immune globulin, human (RIG) decreases effects of rabies vaccine chick embryo cell derived by Other (see comment). Use Caution/Monitor. Comment: RIG may be administered concurrently with and up to 8 days after rabies vaccine. High dose rabies immunoglobulin may impair response to active immunization. .
- rozanolixizumab
rozanolixizumab will decrease the level or effect of rabies immune globulin, human (RIG) by receptor binding competition. Use Caution/Monitor. Coadministration of rozanolixizumab with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing rozanolixizumab and using alternative therapies.
- rubella vaccine
rabies immune globulin, human (RIG) decreases effects of rubella vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
- smallpox (vaccinia) vaccine, live
rabies immune globulin, human (RIG) decreases effects of smallpox (vaccinia) vaccine, live by Other (see comment). Use Caution/Monitor. Comment: High dose rabies immunoglobulin may impair response to active immunization.
- varicella virus vaccine live
rabies immune globulin, human (RIG) decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
Minor (1)
- protein a column
protein a column decreases levels of rabies immune globulin, human (RIG) by Other (see comment). Minor/Significance Unknown. Comment: Since Prosorba binds IgG, it could theoretically interfere with the levels and/or effects of pharmacologic immune globulins.
Adverse Effects
>10%
Injection site pain (33%)
Headache (15%)
1-10%
Muscle pain (9%)
Upper respiratory tract infection (9%)
Joint pain (6%)
Dizziness (6%)
Fatigue (6%)
Abdominal pain (4%)
Blood in urine (4%)
Nausea (4%)
Feeling faint (4%)
Bruising (3%)
Sunburn (3%)
WBCs in urine (3%)
Warnings
Contraindications
None
Cautions
Hemolysis may occur, particularly in individuals at high risk (eg, thrombocytopenia, bleeding disorders)
Monitor patients at increased risk of thrombosis or thrombotic complications for at least 24 hr
Not for intravenous administration
Hypersensitivity reactions, including anaphylaxis, may occur; history of prior systemic allergic reactions to human immunoglobulin preparations places patients at greater risk; have epinephrine available for treatment of acute allergic symptoms; patients with isolated immunoglobulin A(IgA) deficiency may develop severe hypersensitivity reactions to treatment, or subsequently, to the administration of blood products that contain IgA
A transient rise of the various passively transferred antibodies in the patient’s blood may result in misleading positive results of serologic tests; passive transmission of antibodies to erythrocyte antigens (eg, A, B, and D), may interfere with serologic tests for red cell antibodies such as the antiglobulin test (Coombs test)
Administration may interfere with development of an immune response to live attenuated virus vaccines; if feasible, delay immunization with measles vaccine for 4 months and other live attenuated virus vaccines for 3 months after vaccine administration
Because vaccine is made from human plasma donors hyper-immunized with rabies vaccine, may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeld-Jacob disease (vCJD) agent and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent; all infections suspected by a physician possibly to have been transmitted by this product should be reported by the physician or other healthcare provider to Kedrion Biopharma Inc. at 1-855-353-7466
Drug interaction overview
- Patients who can document previous complete rabies pre-exposure prophylaxis or complete post-exposure prophylaxis and have a confirmed adequate rabies antibody titer should receive only a booster rabies vaccine (without immunoglobulin vaccine) because immunoglobulin vaccine may interfere with anamnestic response to vaccine (ACIP)
- Immunoglobulin vaccine can interfere with immune response to rabies vaccine; for this reason, do not exceed recommended dose or give additional (repeat) doses of immunoglobulin vaccine once rabies vaccination has been initiated
- immunoglobulin vaccine can inactivate rabies vaccine; for this reason, do not administer immunoglobulin vaccine in same syringe as rabies vaccine or near anatomical site of administration of the rabies vaccine
- immunoglobulin vaccine contains other antibodies that may interfere with response to live vaccines such as measles, mumps, polio or rubella; avoid immunization with live virus vaccines within 3 months after immunoglobulin vaccine administration, or in the case of measles vaccine, within 4 months after immunoglobulin vaccine administration
Pregnancy & Lactation
Pregnancy
The vaccine has not been studied in pregnant women; therefore, the risk of major birth defects and miscarriage in pregnant women who are exposed to vaccine is unknown; animal developmental or reproduction toxicity studies have not been conducted; not known whether vaccine can cause harm to fetus when administered to a pregnant woman or whether the vaccine can affect reproductive capacity
Lactation
There is no information regarding presence of vaccine in human milk, effects on breastfed infant, or on milk production; developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for vaccine and any potential adverse effects on breastfed infant from vaccine or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Human immune globulins from donors
Pharmcokinetics
Half-life: 17.9 days
Peak plasma time: 7 days (range: 3-14 days)
Administration
Injection
Infiltrate locally around bite; inject any remaining volume IM into the upper arm deltoid region or, in small children, into the anterolateral aspect of the thigh
If IM administration is contraindicated (eg, in patients with uncorrectable bleeding disorders), administer RIG by SC injection (there are no clinical efficacy data to support SC route)
Always administer in conjunction with rabies vaccine (HDCV); however, do not administer into the same anatomical sites as rabies vaccine
Preferably give concomitantly with vaccine but may be given through 7th day after first dose of vaccine
Do not give repeated doses of RIG once rabies vaccine treatment has started, since this may interfere with the immune response to the rabies vaccine
Do not administer RIG to patients with a history of a complete pre-exposure or postexposure vaccination regimen and confirmed adequate rabies antibody titer
Do not mix with the rabies vaccine or administer in the same syringe with the rabies vaccine
Storage
KedRab
- Refrigerate at 2-8ºC (36-46ºF); do not freeze
- May store at room temperature not exceeding 25ºC (77ºF) for up to 1 month; do not return to refrigeration
HyperRAB
- Refrigerate at 2-8ºC (36-46ºF); do not freeze
- May store at room temperature not exceeding 25ºC (77ºF) for up to 6 months; do not return to refrigeration
Imogam Rabies HT, HyperRAB S/D
- Refrigerate at 2-8ºC (36-46ºF); do not freeze
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| HyperRAB S/D (PF) intramuscular - | 150 unit/mL vial |  | |
| HyperRAB S/D (PF) intramuscular - | 150 unit/mL vial |  | |
| Kedrab (PF) intramuscular - | 150 unit/mL vial |  | |
| Kedrab (PF) intramuscular - | 150 unit/mL vial |  | |
| Imogam Rabies-HT (PF) intramuscular - | 150 unit/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
rabies immune globulin (PF) intramuscular
RABIES IMMUNE GLOBULIN - INJECTION
(RAY-beez i-MUNE-GLOB-ue-lin)
COMMON BRAND NAME(S): Hyperrab, Imogam Rabies-HT, KedRab
USES: This medication is used to prevent a certain serious virus infection, rabies, in people who have been exposed to this virus under certain conditions (such as a bite wound or non-bite wound by an infected animal). This medication is made from healthy human blood that has high levels of certain defensive substances (antibodies) that help fight rabies infection.
HOW TO USE: Part of the dose of this medication is given by direct injection by a health care professional into the area of the wound (bite or non-bite). The remainder of your dose is given by injection into a muscle by a health care professional. It is best to receive this medication as soon as possible after exposure. If you wait too long after being exposed, the medication may not work well. Your doctor may also recommend vaccination after receiving this medication. Talk with your doctor about the best treatment for you.The dosage is based on your medical condition and weight.
SIDE EFFECTS: Redness, pain, or tenderness at the injection site may occur. Nausea, vomiting, diarrhea, dizziness, tiredness, headache, or back/joint pain may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist promptly.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before receiving rabies immune globulin, tell your doctor or pharmacist if you are allergic to it; or to other immune globulin products; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: a certain immune system problem (immunoglobulin A deficiency), vaccination/immunization history.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication is made from human blood. Even though the blood is carefully tested, and this medication goes through a special manufacturing process, there is an extremely small chance that you may get infections (such as Creutzfeldt-Jakob disease-CJD) from the medication. Consult your doctor or pharmacist for more information.Tell your doctor of any recent or planned immunizations/vaccinations. This medication may prevent a good response to certain live viral vaccines (such as measles, mumps, rubella, varicella). If you have recently received any of these vaccines, your doctor may have you tested for a response or have you vaccinated again later. If you plan on getting any of these vaccines, your doctor will instruct you about the best time to receive them so you get a good response.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.This medication may interfere with certain lab tests (such as Coomb's test), possibly causing false test results. Tell all lab personnel and all your doctors and pharmacists that you use this medication.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Lab and/or medical tests (such as levels of antibody in the blood) should be done while you are using this medication. Keep all lab appointments. Consult your doctor for more details.
MISSED DOSE: Not applicable.
STORAGE: Not applicable. This medication is given in a hospital or doctor's office and will not be stored at home.
Information last revised August 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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