Post-exposure prophylaxis (PEP) can prevent death due to rabies infection. For every patient not previously vaccinated against rabies, PEP must include wound cleansing, passive immunization with human rabies immune globulin (HRIG), and administration of rabies vaccine.1
PEP consists of a single dose of KEDRAB and a full course of rabies vaccine. The recommended dose of KEDRAB is 20 IU/kg body weight, given at the time of the first vaccine dose. KEDRAB and the first dose of rabies vaccine should be given as soon as possible after exposure, as delays are potentially lethal. However, should a delay occur, KEDRAB should be administered at any time up to and including seven days after the first dose of vaccine. The rabies vaccine should be given according to the manufacturer’s instructions.2
No more than the recommended dose of KEDRAB should be given because KEDRAB partially suppresses active antibody production following vaccination. For the same reason, additional doses of KEDRAB should not be given, even if the antibody response to vaccination is delayed.2
KEDRAB is for wound infiltration and intramuscular use. Do not administer intravenously. Do not mix with the rabies vaccine or administer in the same syringe with the rabies vaccine. Do not administer into the same anatomical site(s) as rabies vaccine. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. If either of these conditions exists, DO NOT use KEDRAB; contact Kedrion Biopharma Customer Service.2
When the bite site is known and infiltration at the bite site is feasible2:
HRIG Administration Video
The following video shows an actual patient being administered 150 IU/mL potency HRIG in the emergency department as part of PEP after a potential rabies exposure.5
When the bite site is unknown or indeterminate (undetectable) or if infiltration is difficult at the bite site (eg, lips, fingers, knee)2:
The 2-mL vial contains a total of 300 IU, which is sufficient for a child weighing 15 kg (33 lb).
The 10-mL vial contains a total of 1500 IU, which is sufficient for an adult weighing 75 kg (165 lb).
Each carton of KEDRAB contains a single-use vial containing 2 mL or 10 mL of ready-to-use solution with a nominal potency of 150 IU/mL.