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Rabies Immune Globulin: Brands, Price & Uses in Bangladesh
Established / Guideline-Supported Use Rabies Immune Globulin is indicated, together with rabies vaccine and more.
About Rabies Immune Globulin
Indications of Rabies Immune Globulin
Established / Guideline-Supported Use
Rabies Immune Globulin is indicated, together with rabies vaccine, for post-exposure prophylaxis (PEP) of rabies in persons who have not previously completed a full pre-exposure or post-exposure rabies vaccination series and who have been bitten, scratched, or otherwise exposed (e.g. mucous membrane or open wound contact with saliva) to an animal suspected or confirmed to be rabid, per WHO and CDC/ACIP guidance.
- WHO Category III exposures (single or multiple transdermal bites/scratches, licks on broken skin, contamination of mucous membranes with saliva, or exposures to bats) — vaccine plus Rabies Immune Globulin.
- WHO Category II exposures in immunocompromised patients are managed as Category III (vaccine plus Rabies Immune Globulin), per WHO recommendation.
Not Indicated
Rabies Immune Globulin is not given to persons with a reliably documented history of complete pre-exposure or post-exposure rabies vaccination (they receive booster vaccine doses only), and it has no role once the active antibody response to the vaccine series is already under way (see Precautions).
Dosage & Administration of Rabies Immune Globulin
Dosing of Rabies Immune Globulin
| Product type | Dose |
|---|---|
| Human Rabies Immune Globulin (HRIG) | 20 IU/kg body weight, given once |
| Equine/Purified Equine Rabies Immune Globulin (ERIG) | 40 IU/kg body weight, given once |
Administration Technique
The full calculated dose of Rabies Immune Globulin should be infiltrated as thoroughly as anatomically possible into and around all wound sites. If the calculated dose exceeds what can be infiltrated locally (e.g. small digits/nose), any remaining volume is given by intramuscular injection at a site distant from the wound. Rabies Immune Globulin must be given at a different anatomical site (e.g. opposite limb) from the concurrently administered rabies vaccine, using a separate syringe and needle, and must never be mixed in the same syringe as the vaccine. Thorough wound washing with soap and water for several minutes is an essential concurrent step and does not replace Rabies Immune Globulin administration.
Rabies Immune Globulin should be given as early as possible after exposure, ideally with the first dose of rabies vaccine (Day 0). See Precautions for the timing cut-off after vaccination has begun.
Side Effects of Rabies Immune Globulin
Common: local pain, tenderness, erythema, or swelling at the infiltration/injection site; low-grade fever; mild headache; myalgia.
Uncommon/rare: urticaria, angioedema; rarely, serum sickness-type reactions (more often with equine-derived Rabies Immune Globulin); rare reports of nephrotic syndrome; anaphylaxis (rare, but can be serious — see Contraindications and Precautions for monitoring advice).
Contraindications of Rabies Immune Globulin
A documented history of a severe (anaphylactic) hypersensitivity reaction to Rabies Immune Globulin itself, or, for equine-derived products, a known severe hypersensitivity to horse serum/equine proteins, is a contraindication.
However, because rabies is almost universally fatal once clinical symptoms appear, a history of hypersensitivity does not remove the need for Rabies Immune Globulin in a genuine high-risk rabies exposure; in that situation it should still be given, under close medical supervision with premedication and resuscitation facilities available, per clinical judgment.
Frequently Asked Questions about Rabies Immune Globulin
What is Rabies Immune Globulin used for?
Rabies Immune Globulin is given, together with rabies vaccine, right after a bite, scratch, or other exposure to a suspected or confirmed rabid animal. It provides immediate, ready-made antibodies to neutralize rabies virus at the wound while the vaccine builds the body's own lasting protection.
Why do I need both Rabies Immune Globulin and the rabies vaccine?
Rabies Immune Globulin works immediately but only lasts a short time, while the rabies vaccine takes about 1-2 weeks to produce the body's own antibodies but gives longer-lasting protection. Using both together closes the gap and gives complete post-exposure protection; one without the other is not considered adequate.
How is Rabies Immune Globulin given?
As much of the dose as possible is carefully injected into and around the wound itself; any remaining amount is injected into a muscle at a different site from the vaccine. It should be given as early as possible, ideally on the same day as the first vaccine dose, and generally not later than 7 days after that first dose.
Can pregnant or breastfeeding women receive Rabies Immune Globulin?
Yes. Pregnancy and breastfeeding are not reasons to avoid Rabies Immune Globulin after a real rabies exposure, since untreated rabies is almost always fatal and the benefit far outweighs any theoretical risk. Your physician will still supervise the injection as with any medicine in pregnancy or lactation.
What are the possible side effects of Rabies Immune Globulin?
Most people experience only mild soreness, redness, or swelling where it was injected, and occasionally a mild fever or headache. Serious allergic reactions are rare but possible, especially with horse-derived products, so you will be observed for a period after the injection.
Who should not receive Rabies Immune Globulin?
People with a known severe allergic reaction to Rabies Immune Globulin itself, or to horse serum for equine-derived products, are usually the only ones to avoid it. Even then, because a real rabies exposure is life-threatening, doctors will still give it under close supervision with allergy treatment on hand if the exposure risk is genuine.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.