Rabies Immune Globulin (Intramuscular Route)

Rabies Immune Globulin is a dose of antibodies that will protect from infection with rabies when the rabies vaccination is being given.

Overview

Rabies Immune Globulin is used in conjunction with the rabies vaccine to prevent the patient from contracting the rabies infection in the body. It is a dose of the antibodies that your body needs to fight the live rabies vaccination. It is used as passive protection in the period before your body is able to develop its own antibodies. At this point, the patient can fight the infection themselves and will be vaccinated against future infection.

Rabies Immune Globulin can also be given to patients that may have been exposed to a risk of infection to rabies. Patients who have received a bite, lick or scratch from an animal that either has or is believed to be infected with rabies will be given a dose of Rabies Immune Globulin to help the body fight the infection. This process is known as post-exposure prophylaxis, meaning the patient is protected after exposure to the infection.

Infection with the rabies virus is very severe and can often be fatal if left untreated. In the United States, there are several wild animals that can be infected with rabies. These animals include skunks, raccoons, bats or other feral animals. Bites from or contact with these animals account for the vast majority of cases of rabies infection in America. A wide range of animals can be infected with rabies, however. In Canada, the most commonly infected animals are skunks, bats, foxes, dogs, and cats, but horses, pigs, and cattle have also been known to become infected with rabies. In most of the rest of the world, feral dogs pose the highest risk for exposing humans to rabies.

If you are in contact with rabid animals in another country you should get treated immediately. You should then also ensure that you contact your doctor on your return home as you may require additional ongoing treatment.

Rabies Immune Globulin can only be administered under the supervision of a doctor and is available as a solution for injection directly into the muscle of the patient.

This treatment is available in the following brands:

  • Bayrab
  • HyperRAB SD
  • Imogam Rabies-HT

Condition treated

  • Rabies
  • Rabies vaccination

Type of medicine

  • Antibodies
  • Post-exposure prophylaxis

Side Effects

In addition to helping the body to fight the rabies infection, the use of Rabies Immune Globulin can also cause unwanted side effects in the patient. While not all of the following side effects may occur, in some cases they may require that you seek additional medical attention.

You should contact your doctor immediately if you experience the following side effects:

  • Bloody urine
  • Cloudy urine
  • Hive-like swellings on:
    • Eyelids
    • Face
    • Feet
    • Hands
    • Legs
    • Lips
    • Sexual organs
    • Throat
    • Tongue
  • Increased blood pressure
  • Infection at the site of injection
  • Selling of the legs or feet
  • Swelling of the face

Other side effects can occur that would not usually require that you seek medical attention. These side effects will usually abate over time, would not be signs of more serious medical conditions and would affect the patient only mildly. If these side effects become bothersome or are ongoing, however, then you should contact your doctor for advice on how to alleviate them. Further treatment to alleviate these conditions may be administered:

  • Fever
  • Skin rash

You may also experience irritation at the site of injection. This is normal and will abate over time. If you see signs of infection at the injection site then you should inform your doctor, but the following irritations will heal in time:

  • Pain
  • Redness
  • Soreness
  • Stiffness of the muscle
  • Tenderness

Other side effects that have not been listed herein may also occur. If you experience any other side effects then you should contact your doctor for advice. If you are worried about your immediate health, however, then you should always contact the emergency services.

Dosage

A nurse or doctor will give this medication to you in a hospital or clinic. It is administered as a shot directly into the upper arm or thigh muscles. If you are being treated for a wound from a rabid animal then it may be injected directly into the wound caused by the animal.

Usually, the dose of this treatment would be given at the same time as your rabies vaccination but it can be given up to 7 days after this.

If you have been bitten by a rabid animal and are not vaccinated against rabies then you must receive this treatment as quickly as possible.

The following is a guideline only and your doctor will determine the correct dose for you:

The usual dose of Rabies Immune Globulin is 20IU/kg.

Interactions

The use of medications can interact with other medications that you are using. In some cases, they may stop other treatments from working or they may react violently with other medications in the body. You should inform your doctor of all medications that you are taking whether they are prescribed medications, over the counter medications or herbal remedies.

The use of Rabies Immune Globulin can interfere with the immune response to other live attenuated virus vaccines. This can occur for a period of up to three months after use, so you should avoid receiving other live vaccines in this period. Live vaccinations that may be affected can include:

  • Measles vaccination (impairment can last for four months in this case)
  • Mumps vaccination
  • Rubella vaccination
  • Varicella vaccination

Other interactions may occur. Inform your doctor of all medications and treatments you are undergoing or have undergone recently before use of this treatment.

Medical problems from which you suffer can make the use of this treatment unsuitable. This is because some conditions may be worsened by this treatment and allergic reactions can occur. You should tell the administering doctor of all medical conditions from which you suffer before receiving this treatment. This is especially important in the following cases:

These conditions may be worsened by use of Rabies Immune Globulin:

  • Bleeding disorders
  • Thrombocytopenia

Rabies Immune Globulin can also cause allergic reactions in patients suffering from:

  • Immunoglobulin A deficiency

Other interactions with medical conditions may also occur. You should inform your doctor of all medical conditions before receiving treatment.

Warnings

Before the use of any medication, you should consider the benefits of use in relation to the risks of use. For Rabies Immune Globulin you should ensure that you have considered all of the following before use:

Allergies:

Inform your doctor if you have ever had an allergic reaction to any medications in the past. You should also inform them of any allergies you have to foods, animals, dyes, preservatives or other substances.

Pediatric:

Safety and efficiency of use in children has not been established. Discuss child use and the specific risks with your doctor before treatment.

Geriatric:

There is no known limitation to the use of Rabies Immune Globulin in the elderly population. Be cautious of age-related conditions that may affect safe use of the treatment.

Pregnancy:

It is unknown whether Rabies Immune Globulin can cause fetal harm in a pregnant woman. This treatment should only be given to a pregnant woman if the treatment is clearly needed. It would not normally be recommended for a mother to have a rabies vaccination during pregnancy.

Breastfeeding:

Studies have shown minimal risk to use of this treatment in nursing mothers. Discuss this with your doctor before use.

Your doctor will need to monitor you when this treatment is administered to check for unwanted side effects. This treatment will be given in a hospital or clinic where you can be monitored.

This medication is produced in donated human blood samples. All blood donations are tested for viruses, but there have been known cases where human blood has transmitted infections on to patients. If you have any questions about this then you should discuss these with your doctor before use.

You should not receive any immunizations or vaccinations without approval from your doctor during the use of Rabies Immune Globulin. Rabies Immune Globulin can affect the use of these vaccinations for up to 3 months after use.

Storage

This medication should be stored refrigerated at 2-8 °C. Do not allow this solution to freeze.

Summary

Rabies Immune Globulin is used in addition to the rabies vaccination to protect you from infection. It is a passive protection that involves the use of antibodies that protect from infection from the live vaccine.

Rabies Immune Globulin can also be used as a post-exposure prophylaxis in patients who have received a bite or scratch from an infected animal.

Patients should not receive any other vaccinations around the time of administration or for a further three months. Rabies Immune Globulin can interfere with live vaccinations for three months or more following use.

 

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Last Reviewed:
January 31, 2018
Last Updated:
January 27, 2018
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