Medicine:Rabies immunoglobulin
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| Trade names | Imogam Rabies-HT, Kedrab, Hyperrab, others |
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| Routes of administration | Intramuscular injection |
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Rabies immunoglobulin (RIG) is a medication made up of antibodies against the rabies virus.[9] It is used to prevent rabies following exposure.[9] It is given after the wound is cleaned with soap and water or povidone-iodine and is followed by a course of rabies vaccine.[9] It is given by injection into the site of the wound and into a muscle.[9] It is not needed in people who have been previously vaccinated against rabies.[10]
Common side effects include pain at the site of injection, fever, and headache.[9] Severe allergic reactions such as anaphylaxis may rarely occur.[11] Use during pregnancy is not known to harm the baby.[9] It works by binding to the rabies virus before it can enter nerve tissue.[9] After the virus has entered the central nervous system, rabies immunoglobulin is no longer useful.[9]
The use of rabies immunoglobulin in the form of blood serum dates from 1891.[12] Use became common within medicine in the 1950s.[13] It is on the World Health Organization's List of Essential Medicines.[14] Rabies immunoglobulin is expensive and hard to come by in the developing world.[15] In the United States it is estimated to be more than US$1,000.00 per dose.[16] It is made from the blood plasma of people or horses who have high levels of the antibody in their blood.[9][16] The horse version is less expensive but has a higher rate of side effects.[16][13]
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.[17][18][1]
Society and culture
Names
There are three versions of rabies immunoglobulin licensed and available in the US.[19] Imogam Rabies-HT is produced by Sanofi Pasteur.[5] Kedrab is produced by Kedrion Biopharma.[17][6] Hyperrab is produced by Grifols.[7]
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[20] and indicate local infusion at the wound site with additional amount intramuscularly at a site distant from vaccine administration.[21]
Kamrab is approved for medical use in Australia.[1]
References
- ↑ 1.0 1.1 1.2 1.3 "Kamrab". 23 August 2021. https://www.tga.gov.au/apm-summary/kamrab.
- ↑ "Kamrab PI". 25 April 2012. https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=97295.
- ↑ "Imogam PI". 25 April 2012. https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=60651.
- ↑ "Hyperrab S/D PI". 25 April 2012. https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=49960.
- ↑ 5.0 5.1 "Imogam Rabies-HT - human rabies virus immune globulin injection, solution". https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bf845cf8-7c01-46c0-97cb-e73a121ff3a7.
- ↑ 6.0 6.1 "Kedrab- human rabies virus immune globulin injection, solution". https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=53f2a23b-c479-4c24-8cab-ee7a33a2633e.
- ↑ 7.0 7.1 "Hyperrab (rabies immune globulin- human injection, solution". https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f82880b8-998c-4659-8f20-6dcc81f258e9.
- ↑ "Hyperrab S/D (rabies immune globulin- human injection". https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6183eb49-fd6e-4ec2-b41f-8a8dcbd9d4f0.
- ↑ 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 "Rabies Immune Globulin". The American Society of Health-System Pharmacists. https://www.drugs.com/monograph/rabies-immune-globulin.html.
- ↑ WHO Model Formulary 2008. World Health Organization. 2009. p. 398. ISBN 9789241547659.
- ↑ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 869. ISBN 9780857111562.
- ↑ "Rabies Vaccines" (in en). Vaccines (6th ed.). [Edinburgh]: Elsevier/Saunders. 2013. p. 659. ISBN 978-1455700905. https://books.google.com/books?id=hoigDQ6vdDQC&pg=PA659.
- ↑ 13.0 13.1 (in en) Travelers' Vaccines. PMPH-USA. 2004. p. 205. ISBN 9781550092257. https://books.google.com/books?id=E7c65R8BhPkC&pg=PA205.
- ↑ World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ↑ Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)) (7 ed.). New York: McGraw-Hill Companies. 2010. pp. 1054. ISBN 978-0-07-148480-0.
- ↑ 16.0 16.1 16.2 (in en) Research Advances in Rabies. Academic Press. 2011. p. 351. ISBN 9780123870414. https://books.google.com/books?id=_jXj0k-KVP4C&pg=PA351.
- ↑ 17.0 17.1 "Kedrab". 21 March 2018. https://www.fda.gov/vaccines-blood-biologics/approved-blood-products/kedrab.
This article incorporates text from this source, which is in the public domain.
- ↑ "Summary Basis for Regulatory Action - Kedrab". FDA. 2017-08-23. https://www.fda.gov/media/107453/download.
- ↑ "Vaccine and Immune Globulin Availability". 26 February 2020. https://www.cdc.gov/rabies/resources/availability.html.
- ↑ "WHO Guide for Rabies Pre and Post Exposure Prophylaxis in Humans". 2014. https://www.who.int/rabies/PEP_Prophylaxis_guideline_15_12_2014.pdf.
- ↑ "Rabies Biologics | Specific Groups | CDC" (in en-us). 2021-01-15. https://www.cdc.gov/rabies/specific_groups/hcp/biologic.html.
Further reading
- (PDF) Meeting of the Antimicrobial Drugs Advisory Committee (Briefing Document). U.S. Food and Drug Administration (FDA). 25 April 2019. https://www.fda.gov/media/123473/download.
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