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Rabies Immune Globulin, Human

( RIGH )

Pronunciation: RAY-beez ih-MYOON GLOB-yoo-lin
Class: Immune globulin

Trade Names

HyperRab
- Injection 150 units/mL

Imogam Rabies-HT
- Injection 150 units/mL

HYPERRAB S/D (Canada)
IMOGAM Rabies Pasteurized (Canada)

Pharmacology

Directly neutralizes rabies virus.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Pharmacokinetics

Absorption

When RIGH and rabies vaccine are given simultaneously, levels of passive rabies antibody were detected 24 h after injection and persisted through the 21-day study.

Indications and Usage

In conjunction with rabies vaccine for postexposure prevention of rabies with one exception: persons who have been previously immunized with rabies vaccine prepared from human diploid cells in a preexposure or postexposure treatment series should receive vaccine only.

Contraindications

Repeated doses of Imogam once vaccine treatment has been initiated.

Dosage and Administration

Adults and children

(Safety and efficacy of HyperRab not established in children): IM 20 units/kg (0.133 mL/kg) as soon as possible after exposure, preferably with first dose of rabies vaccine, but can be administered through the seventh day after the first dose of vaccine is given.

General Advice

  • For IM administration only. Not for intradermal, subcutaneous, IV, intra-arterial, or oral administration.
  • Can be administered in conjunction with rabies vaccine if not combined in the same syringe or administered in the same site.
  • Infiltrate as much immune globulin as possible around the wound if anatomically feasible. Administer remaining immune globulin IM in the upper, outer quadrant of the gluteal muscle or the deltoid muscle.
  • Inspect solution visually before administration. Do not administer if solution is cloudy, discolored, or contains particulate matter.
  • Discard any unused product. Vials are for single-use only. Do not save medication for future use.

Storage/Stability

Store vials in refrigerator (35° to 46°F). Protect from freezing. Do not use if solution has been frozen.

Drug Interactions

Measles, mumps, polio, or rubella live vaccines

Other antibodies in RIGH preparation may interfere with response to these live vaccines. Do not give live vaccines within 3 mo after RIGH.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Headache; malaise.

Dermatologic

Skin rash.

Local

Pain; soreness; stiffness of muscles; tenderness.

Miscellaneous

Anaphylaxis; angioneurotic edema; mild temperature elevations; sensitization to repeated injections.

Precautions

Pregnancy

Category C .

Lactation

Unknown.

Children

HyperRab

Safety and efficacy not established.

Bloodborne viral transmission

Because RIGH is made from human plasma, there is a risk of transmitting infectious agents (eg, viruses).

Hypersensitivity to human immunoglobulins

Give drug with caution.

IgA deficiency

Persons with specific IgA deficiency have increased potential for developing antibodies to IgA and could have anaphylactic reactions to subsequent administration of blood products containing IgA.

Patient Information

  • Review treatment regimen, including dosing schedule, duration of treatment, and monitoring, that will be required.
  • Review benefits of therapy and risks, including potential to transmit disease and unknown infectious agents.
  • Advise patient, family, or caregiver that medication will be prepared and administered by a health care provider in a health care setting and that medication will not be administered at home.
  • Advise patient or caregiver that most common adverse reactions are soreness at injection site and fever. Advise patient or caregiver to use nonaspirin-containing OTC analgesics (eg, acetaminophen, ibuprofen) for fever, pain, or discomfort at injection site.
  • If appropriate, teach patient or caregiver wound care, and signs of infection that should be reported to health care provider.
  • Advise patients or guardians to report any serious adverse reactions to health care provider.

Copyright © 2009 Wolters Kluwer Health.

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