Berirab P Dosage/Direction for Use

Posology: Post-exposure prophylaxis consists of a regimen of one dose of immunoglobulin and full courses of rabies vaccination. Rabies immunoglobulin and the first dose of rabies vaccine should be given as soon as possible after exposure. Additional doses of rabies vaccine should be given according to official guidelines or the manufacturer's instruction.
Rabies prophylaxis exclusively with simultaneous vaccination: recommended dose of rabies immunoglobulin is 20 IU Human Rabies Immunoglobulin (Berirab P) per kg body weight (bw).
Because of the risk of interference with antibody production related to vaccination, neither the dose should be increased nor repeat rabies immunoglobulin be given even if the onset of the simultaneous prophylaxis is delayed.
Method of administration: Human rabies immunoglobulin should be administered via the intramuscular route.
Do not use solutions which are cloudy or contain residues (deposits/particles). Human Rabies Immunoglobulin (Berirab P) is a ready-for-use solution and should be administered at body temperature.
Of the total quantity of rabies immunoglobulin, as much as possible should be instilled deeply into and around the wound. The remainder is to be injected i.m. preferably into the vastus lateralis muscle with the patient lying down.
If comparatively large total volumes are required, it is advisable to administer them in divided doses at different sites. This applies in the case of doses above 2 ml for children up to 20 kg bw and doses above 5 ml for persons above 20 kg bw.
In case of simultaneous prophylaxis the immunoglobulin and the vaccine should be administered at contralateral sites of the body.
The immunoprophylaxis should be carried out immediately even in case that suspicion is not clarified if the animal was infected. Wounds should not be primarily sewed. Parts of the body that are possibly contaminated and all wounds are to be cleaned immediately with soap or detergent, washed well with water and treated with 70 % alcohol or iodine tincture; this is also true for contamination with vaccine solution from vaccination baits.
In the presence of a coagulation disorder, in the case of which intramuscular injections are contraindicated, Human Rabies Immunoglobulin (Berirab P) may be given subcutaneously. Afterwards the injection site should be compressed with a swab.
However, it should be noted that there are no clinical efficacy data to support administration by the subcutaneous route.