Rabies vaccine


Generic Medicine Info
Indications and Dosage
Intramuscular
Preexposure prophylaxis against rabies
Adult: Primary immunisation: ≥2.5 international units/1 mL or ≥2.5 international units/0.5 mL for 3 doses given on Days 0, 7, and 28 (3rd dose may be administered on Day 21 if needed). Booster doses: Booster dose recommendations may vary based on the patient risk category and antibody titre levels. Dosage and vaccination schedule recommendations may vary according to individual products and between countries (refer to specific product or official country guidelines).
Child: Same as adult dose.

Intramuscular
Postexposure prophylaxis of rabies
Adult: In all cases, perform immediate and thorough cleansing of the wound with soap and water. Initiate vaccination as soon as possible after suspected rabies exposure. Previously non-immunised patients: ≥2.5 international units/1 mL or ≥2.5 international units/0.5 mL for 5 doses given on Days 0, 3, 7, 14, and 28. Administer the 1st dose (Day 0) in combination with rabies immunoglobulin in previously non-immunised patients who are at high risk (category III exposure). Previously fully immunised patients: ≥2.5 international units/1 mL or ≥2.5 international units/0.5 mL for 2 doses given on Days 0 and 3. Vaccine administration must be given strictly according to the category of exposure, the immune status of the patient, and the animal status for rabies. Dosage and vaccination schedule recommendations may vary according to individual products and between countries (refer to specific product or official country guidelines).
Child: Same as adult dose.
Reconstitution
Reconstitute with the supplied diluent, then gently swirl to dissolve.
Incompatibility
Do not combine rabies vaccine and rabies immunoglobulin in the same syringe or given at the same inj site.
Contraindications
Hypersensitivity (when used for pre-exposure prophylaxis).
Special Precautions
Patient with history of bleeding disorders (e.g. thrombocytopenia, haemophilia) and those receiving anticoagulant therapy. Immunocompromised patients (e.g. patients receiving chemotherapy or radiation therapy, including high-dose corticosteroids). Consider to defer vaccination during periods of severe immunosuppression. Delay pre-exposure prophylaxis in patients with febrile illness until the fever has resolved. Not for use in patients with a confirmed diagnosis of rabies. Premature infants and children. Pregnancy and lactation.
Adverse Reactions
Significant: Hypersensitivity reactions, including anaphylaxis; serum sickness, syncope; apnoea (particularly in premature infants); meningitis, neuroparalytic events (e.g. encephalitis, transient paralysis), retrobulbar neuritis, multiple sclerosis. Rarely, Guillain-Barre syndrome.
Blood and lymphatic system disorders: Lymphadenopathy.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain.
General disorders and administration site conditions: Inj site pain, erythema, swelling/induration, pruritus, and haematoma; malaise, fever, fatigue, asthenia, chills, influenza-like symptoms.
Immune system disorders: Angioedema.
Metabolism and nutrition disorders: Decreased appetite.
Musculoskeletal and connective tissue disorders: Myalgia, arthralgia.
Nervous system disorders: Dizziness, headache, somnolence, paraesthesia, convulsion.
IM/Parenteral: C
Monitoring Parameters
Monitor for anaphylaxis and syncope for at least 15 minutes after administration. Consider respiratory monitoring when giving primary immunisation series in very premature infants (≤28 weeks gestation) and those with history of respiratory immaturity. Perform serologic testing to detect the presence of rabies virus-neutralising antibodies in high-risk patients, including immunocompromised patients (refer to specific product or local country guidelines).
Drug Interactions
Diminished efficacy with radiation therapy, antimalarials, corticosteroids, and other immunosuppressive agents. Increased risk of bleeding or haematoma with anticoagulants.
Action
Description:
Mechanism of Action: Rabies vaccine is an inactivated virus vaccine that may be prepared from inactivated rabies virus strain PM/WI38 1503-3M cultured on human diploid cells or prepared from inactivated Flury low egg passage (LEP) virus strain produced on purified chick embryo cells. Other cell-cultured vaccines (e.g. Vero cell rabies vaccine) may also be available. It promotes immunity via the induction of rabies-neutralising antibodies.
Onset: Rabies antibody: Approx 7-10 days.
Duration: ≥1 year.
Storage
Store between 2-8°C. Do not freeze. Protect from light.
MIMS Class
Vaccines, Antisera & Immunologicals
ATC Classification
J07BG - Rabies vaccines ; Used for active immunizations.
References
Anon. Rabies Vaccine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 10/10/2022.

Buckingham R (ed). Rabies Vaccines. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/10/2022.

Joint Formulary Committee. Rabies Vaccine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/10/2022.

Rabavert Vaccine (Bavarian Nordic A/S). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/10/2022.

Rabies Vaccine BP ≥2.5 IU/mL, Powder and Solvent for Suspension for Injection (Sanofi Pasteur Europe). MHRA. https://products.mhra.gov.uk. Accessed 10/10/2022.

Seqirus (NZ) Ltd. Rabipur Inactivated Rabies Virus Vaccine, Powder and Solvent for Solution for Injection data sheet 18 January 2022. Medsafe. http://www.medsafe.govt.nz. Accessed 10/10/2022.

Verorab, Powder and Solvent for Suspension for Injection in Prefilled Syringe (Sanofi-Aventis [Malaysia] Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 10/10/2022.

Disclaimer: This information is independently developed by MIMS based on Rabies vaccine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com
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