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Kedrab Dosage

Generic name: Human Rabies Virus Immune Globulin 150[iU] in 1mL
Dosage form: injection, solution

Medically reviewed by Drugs.com. Last updated on Nov 4, 2020.

  • For wound infiltration and intramuscular use. Do not administer intravenously.

Local Treatment of Wounds prior to KEDRAB Administration

The World Health Organization (WHO) and the U.S. Public Health Service Advisory Committee on Immunization Practices (ACIP) have outlined recommendations for passive and active immunization after exposure to an animal suspected of having rabies.1,2,3 Immediate and thorough cleansing of all bite wounds and scratches with soap and water is an important component of post-exposure prophylaxis (PEP). A virucidal agent (e.g., povidone-iodine solution) should be used to irrigate the wounds.

Tetanus prophylaxis and measures to control bacterial infection should be given if medically indicated.

Dosage

Post-exposure prophylaxis consists of a single dose of KEDRAB and a full course of rabies vaccine. The recommended dose of KEDRAB is 20 IU/kg body weight, given at the time of the first vaccine dose. KEDRAB and the first dose of rabies vaccine should be given as soon as possible after exposure, as delays are potentially lethal. However, should a delay occur, KEDRAB should be administered at any time up to and including seven days after the first dose of vaccine. The rabies vaccine should be given according to the manufacturer's instructions.

No more than the recommended dose of KEDRAB should be given because KEDRAB partially suppresses active antibody production following vaccination. For the same reason, additional doses of KEDRAB should not be given, even if the antibody response to vaccination is delayed.

Administration

  • When the bite site is known and infiltration at the bite site is feasible:
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    Infiltrate as much of the dose as possible into and around any detectable bite wounds. Inject any remaining volume intramuscularly into the upper arm deltoid region or, in small children, into the anterolateral aspect of the thigh. Administer the remaining KEDRAB at site(s) distant from the site of the rabies vaccine.
  • Avoid administration into the gluteal region, where absorbance is unpredictable (unless the exposure site is in the gluteal region):
  • When the bite site is unknown or indeterminate (undetectable) or if infiltration is difficult at the bite site (e.g., lips, fingers, knee), administer the full KEDRAB dose by the intramuscular route at a site distant from the site of rabies vaccination.
  • If a large intramuscular volume is required (>2 mL for children or >5 mL for adults), administer the total volume in divided doses at different sites.
  • If intramuscular administration is contraindicated (e.g., in patients with uncorrectable bleeding disorders), administer KEDRAB subcutaneously. However, note that there are no clinical efficacy data to support administration of KEDRAB by the subcutaneous route.
  • Do not mix with the rabies vaccine or administer in the same syringe with the rabies vaccine.
  • Do not administer into the same anatomical site(s) as rabies vaccine.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. If either of these conditions exists, DO NOT use KEDRAB; discard the vial.

Further Information on Rabies Post-Exposure Prophylaxis

Consult local or state public health officials if questions arise about the need for rabies prophylaxis.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.