IntramuscularPreexposure prophylaxis against rabiesAdult: 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.
IntramuscularPostexposure prophylaxis of rabiesAdult: 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.
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Reconstitute with the supplied diluent, then gently swirl to dissolve.
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Do not combine rabies vaccine and rabies immunoglobulin in the same syringe or given at the same inj site.
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Hypersensitivity (when used for pre-exposure prophylaxis).
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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.
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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.
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IM/Intradermal/Parenteral/SC: Z (Use during pregnancy has not been associated with increased risk of adverse pregnancy and neonatal outcomes. Can be given during pregnancy when indicated.)
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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).
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Diminished efficacy with radiation therapy, antimalarials, corticosteroids, and other immunosuppressive agents. Increased risk of bleeding or haematoma with anticoagulants.
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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.
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Store between 2-8°C. Do not freeze. Protect from light.
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J07BG - Rabies vaccines ; Used for active immunizations.
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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.
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