Indications
Rabix-IG is indicated for seroprophylaxis (antibody-based prevention) of rabies in individuals who may have been exposed to the rabies virus, particularly in cases of significant exposure, such as:
- Multiple bites or scratches through the skin
- Contamination of mucous membranes with saliva
- Severe bites on sensitive areas, including the face, head, neck, and hands
- Situations where the responsible domestic or wild animal cannot be assessed or is suspected of being rabid
- Bites inflicted on young children
Rabix-IG provides passive immunity against rabies, ensuring effective prevention for patients who have come into contact with a rabid animal or one suspected to be rabid. It’s important to note that the anti-rabies serum alone does not serve as a standalone treatment for rabies and should always be administered in conjunction with the rabies vaccine.
Consult a registered medical professional before use.
Dosage & Administration
First-aid Treatment: Immediate local care for bite wounds and scratches that might be contaminated with the rabies virus is crucial, regardless of the time since exposure. The recommended initial measures include thoroughly flushing and cleaning the wound with soap, water, or any detergent known to effectively neutralize the rabies virus. Administer the rabies immune globulin as soon as possible after exposure.
The suggested dosage for both adults and children is 40 IU/kg of body weight. Whenever anatomically feasible, the majority of the dose should be infiltrated directly around and into the affected wound(s). The remaining volume should be given intramuscularly in a single injection, preferably into the gluteal region.
For children, especially in cases involving multiple wounds, it’s advisable to dilute the dose 2-3 times in a 0.9% sodium chloride solution to ensure sufficient quantities of equine rabies immune globulin infiltrate the wounds properly. Caution should be exercised when infiltrating wounds in specific anatomical locations, such as fingertips, to avoid increased local pressure.
For rabies prevention, a combined treatment of immune globulin and vaccine is recommended. The first dose of the rabies vaccine should be administered simultaneously with the rabies immunoglobulin but at different injection sites. If rabies immunoglobulin is unavailable at the time of the first rabies vaccine dose, it can still be given within 7 to 8 days afterward. Additionally, anti-tetanus treatment and antibiotics may be necessary to manage infections unrelated to rabies.
According to the World Health Organization’s expert committee on rabies, the following therapeutic recommendations are advised based on the type of contact with a suspected or confirmed rabid animal:
| Category | Type of Contact | Recommended Treatment |
|---|---|---|
| Touching or feeding, licks on intact skin | None, if reliable case history is available | |
| Nibbling of uncovered skin, minor scratches, superficial bites (except on head, neck, shoulder girdle, arms, or hands), or abrasions without bleeding, licks on broken skin | Administer vaccine on Day 0, D3, D7, D14, and D28. Treatment can be stopped if the animal remains healthy during the 10-day observation period or if it is humanely killed and tests negative. | |
| Single or multiple bites or scratches, especially on sensitive areas like the head, neck, shoulders, arms, or hands; contamination of mucous membranes with saliva (licks on broken skin) | Administer rabies vaccine immediately on Day 0, D3, D7, D14, and D28 or D90 (optional), and rabies immune globulin on Day 0. Treatment may be stopped if the animal remains healthy during the observation period or if it is humanely killed and found to be negative. |
Consult a registered medical professional before use.
Contraindications
Use of Rabix-IG is contraindicated in individuals with a known history of allergic reactions to horse proteins. However, the severe risk associated with rabies outweighs any potential contraindications.
Side Effects
Patients may experience immediate or delayed hypersensitivity reactions upon administration of rabies immune globulin. Immediate reactions may include hypotension, difficulty breathing, and urticaria, while delayed reactions can manifest as inflammatory responses, fever, itching, rash or urticaria, lymphadenopathy, and joint pain.
Pregnancy & Lactation
The safety of rabies immune globulin during pregnancy has not been established through clinical trials. Given the critical risk associated with rabies, pregnancy should not preclude the administration of rabies immune globulin following exposure.
Precautions & Warnings
Rabix-IG should not be administered intravenously due to the risk of shock (sudden collapse with blood pressure drop). Ensure that the needle does not enter a blood vessel during administration. It is crucial to avoid repeated doses of Rabix-IG, as this may diminish the protective efficacy provided by the vaccine. Shake the vial gently before use, but do not shake vigorously.
Overdose Effects
Exceeding the recommended dosage may lead to immunosuppressive effects, potentially interfering with the effectiveness of the rabies vaccine.
Therapeutic Class
Vaccines, Anti-sera & Immunoglobulin
Storage Conditions
Keep out of the reach and sight of children. Store between 2°C and 8°C and transport at the same temperature range. Protect from light and avoid freezing.
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