Human Diploid Cell Rabies Vaccine

From Anvita Health Wiki

Contents 1 Indications 2 Contraindications 3 Dosage 4 Pharmacokinetics 5 Monitor 6 Drug-interactions 7 Mechanism-of-action 8 More General Terms 9 Additional Terms 10 References

Indications

• stimulate active immunity in individuals exposed the the disease or virus

Contraindications

• (& cautions)
• developing febrile illnesses
• allergy to neomycin, gentamicin or amphotericin B
• caution: administer IM only

• pregnancy-category C
• safety in lactation ?

Dosage

• Post-exposure prophylaxis:

• 1.0 mL IM on days 1 & 3 post animal bite in a victim previously immunized or on days 1, 3, 7, 14 following rabies immune globulin ( RIG) in an unvaccinated victim.
• Alternatively, rabies vaccine adsorbed ( RVA) may be used.

• Pre-exposure prophylaxis:

• A series of 3 injections is given 0.1 mL intradermally in deltoids on days 0, 7 & 28, or
• A series of 3 doses given 1 mL IM in deltoid on days 0, 7 & 21 or 28.
• Booster doses can be given every 2 years

• Injection:

• 2.5 units of rabies antigen/ mL (single dose with diluent)

Pharmacokinetics

• after IM administration, antibody appears in the serum within 7-10 days & persists for at least 1 year
• elimination: liver

Monitor

• antibody-response to vaccine in immunocompromised patients, i.e. formation of rabies immune globulin [4] Adverse reactions:
• common (> 10%)

• swelling, erythema, itching, pain, local discomfort, nausea, headache, abdominal pain, muscle aches, dizziness, malaise, neuroparalytic reactions, hypersensitivity reactions

Drug-interactions

• rabies immune globulin
• chloroquine: decreased titer of antibody
• immunosuppressive agents: decreased response to vaccine
• corticosteroids

Mechanism-of-action

• stimulates active immunity to rabies by promoting production of rabies antibody

More General Terms

• vaccine

Additional Terms

• rabies immune globulin (RIG, Hyperab Imogam)
• rabies vaccine adsorbed (RVA, RabAvert)
• rabies virus

References

1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1171
2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
4. Anvita Health guideline :id 1101
5. Rupprecht CE et al Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices MMWR March 19, 2010 / 59(02);1-9 <PubMed> PMID: [1] <Internet> [2]
6. National Guideline Clearinghouse Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices (ACIP). ngc-guideline: [3]

human diploid cell rabies vaccine (Imovax, Imovax ID, HDCV)