Rabies immunoglobulin

Rabies immunoglobulin
Clinical data
Trade namesImogam Rabies-HT, Kedrab, Hyperrab, others
AHFS/Drugs.comMonograph
Pregnancy
category
Routes of
administration		Intramuscular injection
ATC code
Legal status
Legal status
Identifiers
DrugBank
ChemSpider
  • none
UNII

Rabies, a viral zoonotic neglected tropical disease, poses a severe public health threat in over 150 countries and territories, primarily in Asia and Africa.[10] Each year, this disease results in tens of thousands of fatalities, with children under 15 accounting for 40% of these deaths.[10] Rabies infects mammals and is spread to humans and other animals by contact with saliva, most commonly through bites and scratches. Worldwide, nearly all human rabies cases are caused by dog bites and scratches.[10] However, in the United States, bats are now the primary source of human rabies due to the diligent vaccination of dogs against rabies.[10]

Rabies immunoglobulin (RIG) is a medication made up of antibodies against the rabies virus.[11] It is used to prevent rabies following exposure.[11] It is given after the wound is cleaned with soap and water or povidone-iodine and is followed by a course of rabies vaccine.[11] It is given by injection into the site of the wound and into a muscle.[11] It is not needed in people who have been previously vaccinated against rabies.[12]

Common side effects include pain at the site of injection, fever, and headache.[11] Severe allergic reactions such as anaphylaxis may rarely occur.[13] Use during pregnancy is not known to harm the fetus.[11] It works by binding to the rabies virus before it can enter nerve tissue.[11] After the virus has entered the central nervous system, rabies immunoglobulin is no longer useful.[11]

The use of rabies immunoglobulin in the form of blood serum dates from 1891.[14] Use became common within medicine in the 1950s.[15] It is on the World Health Organization's List of Essential Medicines.[16] Rabies immunoglobulin is expensive and hard to come by in the developing world.[17] In the United States it is estimated to be more than US$1,000.00 per dose,[18] and around £600 in the United Kingdom.[19] It is made by isolating rabies immunoglobulin from donated blood plasma of humans or horses who have high levels of the immunoglobulin.[11][18] The equine preparation is less expensive but has a higher rate of side effects.[18][15]

  1. ^ a b "Kamrab". Therapeutic Goods Administration (TGA). 23 August 2021. Retrieved 10 September 2021.
  2. ^ "Kamrab PI". Health Canada. 25 April 2012. Retrieved 10 September 2021.
  3. ^ "Imogam PI". Health Canada. 25 April 2012. Retrieved 10 September 2021.
  4. ^ "Hyperrab S/D PI". Health Canada. 25 April 2012. Retrieved 10 September 2021.
  5. ^ "Drug and medical device highlights 2018: Helping you maintain and improve your health". Health Canada. 14 October 2020. Retrieved 17 April 2024.
  6. ^ Cite error: The named reference Imogam Rabies-HT FDA label was invoked but never defined (see the help page).
  7. ^ Cite error: The named reference Kedrab FDA label was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference Hyperrab FDA label was invoked but never defined (see the help page).
  9. ^ "Hyperrab S/D (rabies immune globulin- human injection". DailyMed. Retrieved 10 September 2021.
  10. ^ a b c d "Rabies". World Health Organization (WHO). 5 June 2024. Retrieved 12 March 2025.
  11. ^ a b c d e f g h i "Rabies Immune Globulin". The American Society of Health-System Pharmacists. Archived from the original on 18 March 2011. Retrieved 8 January 2017.
  12. ^ World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 398. hdl:10665/44053. ISBN 9789241547659.
  13. ^ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 869. ISBN 9780857111562.
  14. ^ Rupprecht CE, Plotkin SA (2013). "Rabies Vaccines". In Plotkin SA, Orenstein WA, Offit PA (eds.). Vaccines (6th ed.). [Edinburgh]: Elsevier/Saunders. p. 659. ISBN 978-1455700905. Archived from the original on 9 January 2017.
  15. ^ a b Jong EC, Zuckerman JN (2004). Travelers' Vaccines. PMPH-USA. p. 205. ISBN 9781550092257. Archived from the original on 9 January 2017.
  16. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  17. ^ Tintinalli JE (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)) (7 ed.). New York: McGraw-Hill Companies. p. 1054. ISBN 978-0-07-148480-0.
  18. ^ a b c Research Advances in Rabies. Academic Press. 2011. p. 351. ISBN 9780123870414. Archived from the original on 9 January 2017.
  19. ^ Kliff, Sarah (7 February 2018). "Why a simple, lifesaving rabies shot can cost $10,000 in America". Vox. Retrieved 26 September 2024.
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