Rabies immunoglobulin

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

Rabies immunoglobulin (RIG) is a medication made up of antibodies against the rabies virus. [10] It is used to prevent rabies following exposure. [10] It is given after the wound is cleaned with soap and water or povidone-iodine and is followed by a course of rabies vaccine. [10] It is given by injection into the site of the wound and into a muscle. [10] It is not needed in people who have been previously vaccinated against rabies. [11]

Contents

Common side effects include pain at the site of injection, fever, and headache. [10] Severe allergic reactions such as anaphylaxis may rarely occur. [12] Use during pregnancy is not known to harm the baby. [10] It works by binding to the rabies virus before it can enter nerve tissue. [10] After the virus has entered the central nervous system, rabies immunoglobulin is no longer useful. [10]

The use of rabies immunoglobulin in the form of blood serum dates from 1891. [13] Use became common within medicine in the 1950s. [14] It is on the World Health Organization's List of Essential Medicines. [15] Rabies immunoglobulin is expensive and hard to come by in the developing world. [16] In the United States it is estimated to be more than US$1,000.00 per dose, [17] and around £600 in the United Kingdom. [18] It is made by isolating rabies immunoglobulin from donated blood plasma of humans or horses who posses high levels of the immunoglobulin. [10] [17] The equine preparation is less expensive but has a higher rate of side effects. [17] [14]

Medical uses

Rabies immunoglobulin (RIG) is indicated for the passive, transient post-exposure prophylaxis of rabies infection, when given immediately after contact with a rabid or possibly rabid animal and in combination with a rabies vaccine. [19] [20] [1]

Society and culture

Names

There are three versions of rabies immunoglobulin licensed and available in the US. [21] Imogam Rabies-HT is produced by Sanofi Pasteur. [6] Kedrab is produced by Kedrion Biopharma. [19] [7] Hyperrab is produced by Grifols. [8]

Imogam Rabies-HT and Kedrab have a nominal potency of 150 IU/mL while Hyperrab has a nominal potency of 300 IU/mL and requires smaller dosing. All three versions are used for post-exposure [22] and indicate local infusion at the wound site with additional amount intramuscularly at a site distant from vaccine administration. [23]

Kamrab is approved for medical use in Australia. [1]

References

  1. 1 2 3 4 "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. 1 2 "Imogam Rabies-HT - human rabies virus immune globulin injection, solution". DailyMed. Retrieved 24 March 2020.
  7. 1 2 "Kedrab- human rabies virus immune globulin injection, solution". DailyMed. Retrieved 24 March 2020.
  8. 1 2 "Hyperrab (rabies immune globulin- human injection, solution". DailyMed. Retrieved 24 March 2020.
  9. ↑ "Hyperrab S/D (rabies immune globulin- human injection". DailyMed. Retrieved 10 September 2021.
  10. 1 2 3 4 5 6 7 8 9 "Rabies Immune Globulin". The American Society of Health-System Pharmacists. Archived from the original on 18 March 2011. Retrieved 8 January 2017.
  11. ↑ 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.
  12. ↑ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 869. ISBN   9780857111562.
  13. ↑ 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.
  14. 1 2 Jong EC, Zuckerman JN (2004). Travelers' Vaccines. PMPH-USA. p. 205. ISBN   9781550092257. Archived from the original on 9 January 2017.
  15. ↑ 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.
  16. ↑ 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.
  17. 1 2 3 Research Advances in Rabies. Academic Press. 2011. p. 351. ISBN   9780123870414. Archived from the original on 9 January 2017.
  18. ↑ Kliff, Sarah (7 February 2018). "Why a simple, lifesaving rabies shot can cost $10,000 in America". Vox. Retrieved 26 September 2024.
  19. 1 2 "Kedrab". U.S. Food and Drug Administration (FDA). 21 March 2018. Retrieved 7 June 2020.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  20. ↑ "Summary Basis for Regulatory Action - Kedrab". FDA. 23 August 2017.
  21. ↑ "Vaccine and Immune Globulin Availability". Centers for Disease Control and Prevention (CDC). 26 February 2020. Retrieved 24 March 2020.
  22. ↑ "WHO Guide for Rabies Pre and Post Exposure Prophylaxis in Humans" (PDF). World Health Organization (WHO). 2014.
  23. ↑ "Rabies Biologics | Specific Groups | CDC". www.cdc.gov. 15 January 2021. Retrieved 18 November 2022.

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