Drug Interactions between HyperRAB S/D and rabies vaccine, human diploid cell

GENERALLY AVOID: Exceeding the recommended dosage of human rabies immune globulin may reduce the immune response to rabies vaccine. Studies have shown that administration of prophylactic rabies antibody can interfere to a variable extent with the active immunity induced by the vaccine, but that the impact could be minimized by booster doses of vaccine after the end of the usual dosage series. In carefully controlled clinical studies, when a human rabies immune globulin dose of 20 IU/kg of rabies antibody was given simultaneously with the first dose of vaccine, levels of passive rabies antibody were detected 24 hours after injection in all individuals. There was minimal or no interference with the immune response to the initial and subsequent doses of vaccine, including booster doses.

MANAGEMENT: Human rabies immune globulin should be administered at the time of the first dose of rabies vaccine, or up to the eighth day after the first dose of vaccine is given. Under no circumstances should human rabies immune globulin be administered in the same syringe or at the same anatomical site as the vaccine. Because human rabies immune globulin may partially suppress active production of antibody, no more than the recommended dosage of 20 IU/kg should be given. In addition, repeated doses of rabies immune globulin should not be administered once vaccine treatment has been initiated, as this may also interfere with maximum active immunity expected from the vaccine.