Drug Index

Rabies Vaccine

Mechanism :

Rabies vaccine is a sterile freeze-dried vaccine obtained by growing fixed-virus strains in primary cultures of chicken fibroblasts. The growth medium for propagation of the virus is a synthetic cell culture medium with the addition of human albumin, polygeline (processed bovine gelatin) and antibiotics. The virus is inactivated with propiolactone, and further processed by zonal centrifugation in a sucrose density-gradient.

Indication :

  • Rabies prophylaxis

Contraindications :

Since rabies is almost always fatal, there is no contraindication to post-exposure immunization. However, if an alternative product (e.g. HDCV) is not available, care should be taken if the vaccine is to be administered to persons known to be sensitive to processed bovine gelatin, chicken protein, neomycin, chlortetracycline and amphotericin B in trace amounts, which may be present in the vaccine and may cause an allergic reaction in such individuals.

Dosing :

Can be given intradermal (ID) or IM.One ID dose is 0.1 mL of vaccine; one IM dose is 0.5 mL or 1.0 mL depending on the product.
Days 0, 7 and 28. Boosters may be given every 2-3 years if there is continuing risk and if post-exposure treatment is not readily available. After 2-3 boosters/expert advice should be sought before giving more.
When an individual has been exposed via a break in the skin or contamination of a mucosal surface to a potentially rabid animal, consideration should be given to post-exposure treatment.
Unimmunized or incompletely immunized: Give on days 0, 3, 7, 14 and 30 plus rabies Immunoglobulin. Alternative: 4-dose Zagreb regimen (2-site IM on day 0 and 1-site IM on days 7 and 21).
Fully immunized Individual: Give on days 0, 3 and 7. For all age groups ID injection sites are the deltoid region and either the anterolateral thigh or suprascapular regions. The recommended site for IM administration is the deltoid area of the arm for adults and children aged ≥2 years, and the anterolateral area of the thigh for children aged <2 years.

Adverse Effect :

Local reactions such as redness, swelling and tenderness have been recorded within 48 hours after the injection. Mild fever, malaise and flu-like symptoms may also occur.

Interaction :

Corticosteroids, other Immunosuppressive Agents, Antimalarials and Immunosuppressive Illnesses: Can interfere with the development of active immunity after vaccination and may diminish the protective efficacy of the vaccine.

Hepatic Dose :

No dose adjustment recommended.
02/14/2024 22:23:51 Rabies Vaccine
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