Rabies Immune Globulin, Human (RIGH)
( RIGH ) Pronunciation: (RAY-beez ih-MYOON GLOB-yoo-lin)Class: Immune globulin
Trade Names:HyperRab- Injection 150 units/mL
Trade Names:Imogam Rabies-HT- Injection 150 units/mLHYPERRAB S/D
(Canada)IMOGAM Rabies Pasteurized
Directly neutralizes rabies virus.
When RIGH and rabies vaccine are given simultaneously, levels of passive rabies antibody were detected 24 h after injection and persisted through the 21-day study.
Indications and Usage
In conjunction with rabies vaccine for postexposure prevention of rabies with one exception: persons who have been previously immunized with rabies vaccine prepared from human diploid cells in a preexposure or postexposure treatment series should receive vaccine only.
Repeated doses of Imogam once vaccine treatment has been initiated.
Dosage and AdministrationAdults and children
(Safety and efficacy of HyperRab not established in children): IM 20 units/kg (0.133 mL/kg) as soon as possible after exposure, preferably with first dose of rabies vaccine, but can be administered through the seventh day after the first dose of vaccine is given.
- For IM administration only. Not for intradermal, subcutaneous, IV, intra-arterial, or oral administration.
- Can be administered in conjunction with rabies vaccine if not combined in the same syringe or administered in the same site.
- Infiltrate as much immune globulin as possible around the wound if anatomically feasible. Administer remaining immune globulin IM in the upper, outer quadrant of the gluteal muscle or the deltoid muscle.
- Inspect solution visually before administration. Do not administer if solution is cloudy, discolored, or contains particulate matter.
- Discard any unused product. Vials are for single-use only. Do not save medication for future use.
Store vials in refrigerator (35° to 46°F). Protect from freezing. Do not use if solution has been frozen.
Drug InteractionsMeasles, mumps, polio, or rubella live vaccines
Other antibodies in RIGH preparation may interfere with response to these live vaccines. Do not give live vaccines within 3 mo after RIGH.
Laboratory Test Interactions
None well documented.
Pain; soreness; stiffness of muscles; tenderness.
Anaphylaxis; angioneurotic edema; mild temperature elevations; sensitization to repeated injections.
Category C .
Safety and efficacy not established.
Bloodborne viral transmission
Because RIGH is made from human plasma, there is a risk of transmitting infectious agents (eg, viruses).
Hypersensitivity to human immunoglobulins
Give drug with caution.
Persons with specific IgA deficiency have increased potential for developing antibodies to IgA and could have anaphylactic reactions to subsequent administration of blood products containing IgA.
- Review treatment regimen, including dosing schedule, duration of treatment, and monitoring, that will be required.
- Review benefits of therapy and risks, including potential to transmit disease and unknown infectious agents.
- Advise patient, family, or caregiver that medication will be prepared and administered by a health care provider in a health care setting and that medication will not be administered at home.
- Advise patient or caregiver that most common adverse reactions are soreness at injection site and fever. Advise patient or caregiver to use nonaspirin-containing OTC analgesics (eg, acetaminophen, ibuprofen) for fever, pain, or discomfort at injection site.
- If appropriate, teach patient or caregiver wound care, and signs of infection that should be reported to health care provider.
- Advise patients or guardians to report any serious adverse reactions to health care provider.
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