Trade Names:Imovax (Human Diploid Cell)- Powder for injection, freeze-dried suspension of rabies virus strain PM-1503-3M grown in human diploid cell cultures (inactivated whole virus). Contains at least 2.5 international units rabies antigen/mL.
Trade Names:RabAvert- Powder for injection, freeze-dried fixed-virus strain Flury LEP grown in cultures of chicken fibroblasts. Contains at least 2.5 international units rabies antigen/mL.
Induces neutralizing antibodies and cellular immunity.
Induction of active immunity against rabies virus either before or after viral exposure.
No known contraindications.Preexposure
Developing febrile illness ( Imovax ); history of anaphylaxis to any component of the product ( RabAvert ).
IM 1 mL on days 0, 7, and 21 or 28. A booster dose may be given as needed to maintain an adequate titer in persons working with live rabies virus in research laboratories and in vaccine production facilities. Rabies antibody titers should be checked every 6 mo. Laboratory workers, such as those doing rabies diagnostic tests, spelunkers, veterinarians, and animal control and wildlife officers in areas where rabies is epizootic should have boosters every 2 yr or have their serum tested for rabies antibody every 2 yr.Postexposure ProphylaxisAdults and Children
IM Following administration of rabies immune globulin (RIG) on day 0, give 1 mL of rabies vaccine on days 0, 3, 7, 14, and 28. If a previously immunized person vaccinated with a cell culture vaccine or who previously demonstrated rabies antibody is exposed to rabies, that person should receive 2 IM doses of 1 mL each, one immediately and one 3 days later. RIG should not be given.
Store at 35° to 46°F. Do not freeze.RabAvert
Store at 36° to 46°F. Protect from light.
May result in insufficient response to immunization. If possible, do not give immunosuppressive agents during postexposure therapy.
None well documented.
Hot flashes, palpitations (postmarketing).
Headache (52%); dizziness, malaise (20%); encephalitis, Guillain-Barré syndrome, meningitis, multiple sclerosis, neuroparalysis, neuroparalytic reactions, retrobulbar neuritis, transient paralysis, vertigo, visual disturbance (postmarketing).
Rash; pruritus, urticaria (postmarketing).
Abdominal pain, nausea (20%).
Pain (84%); erythema and itching or swelling at injection site (25%); extensive limb swelling, induration (postmarketing).
Myalgia (53%); muscle aches (20%); arthralgia; myelitis (postmarketing).
Anaphylactic reactions; flu-like symptoms, including asthenia, fatigue, and fever; anaphylaxis, edema, type III hypersensitivity-like reactions (postmarketing).
Perform serologic testing in immunocompromised patients.
Category C .
Safety and efficacy not established ( Imovax ).
In persons who experience immune complex–like (or serum sickness–like) hypersensitivity reactions during preexposure prophylaxis, do not give further doses of rabies vaccine unless they are exposed to rabies or they are likely to be unapparently or unavoidably exposed to rabies virus and have unsatisfactory antibody titers.
Guillain-Barré syndrome has been rarely associated with Imovax administration.
Can interfere with the development of active immunity and predispose the patient to developing rabies.
Because RabAvert contains albumin, a derivative of human blood, there is a risk of transmitting infectious agents (eg, viruses), including Creutzfeldt-Jakob disease.
Copyright © 2009 Wolters Kluwer Health.