Immunoglobulin is needed for rabies vaccination. Anti-rabies immunoglobulin - a cure for rabies. Method of administration of the vaccine and dose.

Rabies immunoglobulin from horse blood serum liquid is an immunological drug intended for the prevention of a particularly serious disease called rabies.

Composition and release form

The active component is horse anti-rabies immunoglobulin, the content of which is at least 150 IU per milliliter of solution. Excipients are represented only by glycol, which acts as a stabilizer, sodium chloride and water for injection.

The drug is supplied as a clear, yellowish solution for injection. The presence of faintly noticeable opalescence is acceptable. Available in ampoules of 3, 5 and 10 milliliters. These medicine containers are marked blue.

Each delivery kit is supplied with a second ampoule of immunoglobulin, but at a dilution of 1:100, used to assess the body's response. These containers are marked in red. Not on sale. Supplied exclusively to inpatient or outpatient medical institutions.

pharmachologic effect

Rabies is deadly viral disease, transmitted by contact, occurring against the background of severe damage to the central nervous system. It should be noted that without preventive vaccination, carried out shortly after the suspected infection, this disease is fatal in 100 percent of cases.

Rabies immunoglobulin contains virus-neutralizing antibodies specific to the rabies pathogen, in an amount of at least 150 international units per 1 milliliter of solution. This substance is produced by the rivanol-alcohol method (protein fractionation) from horse blood serum.

Timely administration of immunoglobulin after an animal bite can completely neutralize the rabies virus and lead to complete cure sick.

Indications for use

The use of rabies immunoglobulin is indicated only as an element of complex prevention of rabies (hydrophobia) in case of exposure to wild animals.

Contraindications for use

Considering the degree of lethality of rabies, there are no contraindications to the use of immunoglobulin.

However, it should be noted that if a pronounced reaction occurs when a drug diluted 1:100 is administered, immunoglobulin should be administered only in a treatment room equipped with everything necessary for resuscitation measures.

Application and dosage

A cut after a bite from a suspicious animal should undergo initial treatment of the damaged area of the body. To do this, wash the bite site with water and regular soap or detergent. In addition, you need to treat the wound with 40 - 70 percent alcohol or strong alcohol. It is acceptable to use iodine solution.

After the initial treatment, you can resort to specific treatment; it is very important not to waste precious time. After 3 days after the bite, any treatment may be useless.

The suitability of the drug should first be assessed. The ampoule with the medicine must not be damaged. It must be marked, as well as the release date, batch number and manufacturer information. The presence of inclusions or insoluble sediment is unacceptable.

Opening of ampoules should be carried out only in a treatment room, with mandatory observance of all rules of asepsis and antisepsis. The effective dosage of immunoglobulin is 40 international units per kilogram of patient body weight.

Before administering immunoglobulin, an intradermal test must be performed to assess the body's reaction to a foreign protein. For this purpose, a solution of the drug diluted in a ratio of 1:100 is used. The injection is made into the flexor surface of the forearm.

If the intradermal test results are negative, the drug is administered in several doses. The first is in the amount of 0.7 milliliters. After 30 minutes, 3 more injections of immunoglobulin are given. There should be a 15-minute pause between each administration. The solution temperature should be 37 degrees.

The site of immunoglobulin injection depends on the lesion. The bitten area should be infiltrated with the drug solution. In addition, part of the medicine must be injected deep into the wound. The remaining amount of solution is injected into other places: the buttock or the deltoid muscle area.

If the intradermal test is positive, the administration of immunoglobulin should be carried out with special precautions. To begin with, a drug diluted 1:100 is injected into the subcutaneous tissue of the shoulder in a dose of 0.5, 2 and 5 milliliters. The interval between procedures is 15 minutes.

If the reaction is positive, the administration of immunoglobulin should be accompanied by the use of antihistamines (diphenhydramine, suprastin), solutions of adrenaline or ephedrine.

After completion of the procedure, the patient must be under constant supervision of medical personnel for at least an hour. The procedure itself must be registered in special journals, indicating data about the vaccine and the name of the health worker who performed the manipulation.

Side effects

The administration of immunoglobulin may be accompanied by severe allergic reactions, including anaphylactic shock or serum sickness.

Analogs

Analogs include: Imogam Raj, Anti-rabies Immunoglobulin from human serum, Rebinolin, Anti-rabies Immunoglobulin.

Conclusion

We have reviewed the product “Antirabies immunoglobulin from horse blood serum (liquid)”, instructions for use, application, indications, contraindications, action, side effects, analogs, composition, dosage. If rabies is suspected, it is vital not to waste time. As mentioned earlier, after three days, specific treatment may not be effective.

Instructions for use:

ANTI-RABIC IMMUNOGLOBULIN FROM HORSE BLOOD SERUM, LIQUID

Registration number R N002639/01 dated July 23, 2008.

Dosage form. Injection

Rabies immunoglobulin from horse blood serum liquid is a gamma globulin fraction of horse immune serum obtained by the rivanol-alcohol method. The activity of the drug is not less than 150 IU/ml. Stabilizer - glycocol (glycine) at a concentration of (2.25 ± 0.25)%.

Description.

Rabies immunoglobulin is a clear or slightly opalescent liquid, colorless to slightly yellow. Immunoglobulin diluted 1:100 is a clear, colorless liquid.

Immunological properties.

Rabies immunoglobulin has the ability to neutralize the rabies virus.

Purpose.

Used in combination with an anti-rabies vaccine to prevent people from developing hydrophobia due to severe bites from rabid or suspected rabid animals.

Directions for use and dosage.

Local treatment of wounds (bites, scratches, abrasions) and salivation sites should begin immediately or as soon as possible after a bite or injury. It consists of abundantly washing the wound surface for several minutes (up to 15 minutes) with soap and water or other detergent(detergent) or in the absence of soap or detergent, wash the damaged area with a stream of water. After this, the edges of the wound should be treated 70% ethyl alcohol or 5% aqueous-alcoholic iodine solution. Sutures should be avoided whenever possible.

Suturing is indicated only in the following cases:

For extensive wounds - several guiding skin sutures after pre-treatment of the wound;

For cosmetic reasons (skin sutures on facial wounds);

Stitching of bleeding vessels to stop external bleeding.
If there are indications for the use of rabies immunoglobulin, it is used immediately before suturing.

After local treatment of the wound, therapeutic and prophylactic immunization is immediately started. Rabies immunoglobulin must be administered no later than three days after being bitten or injured by a rabid or suspected rabid animal. The most effective administration of the drug is on the first day after injury.

Before injection, check the integrity of the ampoules and the presence of markings on them. The drug is not suitable for use in ampoules with damaged integrity, labeling, as well as when its physical properties (color, transparency, etc.) have changed, the expiration date has expired and improper storage.

The opening of the ampoules and the procedure for administering the drug are carried out in strict compliance with the rules of asepsis and antiseptics.

When providing anti-rabies care, immunoglobulin is first administered and, no more than 30 minutes after it, the anti-rabies vaccine is administered. Anti-rabies immunoglobulin(ampoules are marked with a label with blue text) are administered at a dose of 40 IU per 1 kg of body weight of an adult or child. The entire dose of rabies immunoglobulin is administered within one hour. The volume of administered heterologous rabies immunoglobulin should not exceed 20 ml.

Example: the victim’s body weight is 60 kg; immunoglobulin activity (indicated on the package label) - 200 IU/ml. In order to determine the dose of immunoglobulin required for administration, you need to multiply the victim’s body weight (60 kg) by 40 IU and divide the resulting number by the activity of the drug (200 MB), that is, 60 * 40 / 200 = 12 ml.

Before administering rabies immunoglobulin, to detect sensitivity to a foreign protein, an intradermal test with immunoglobulin diluted 1:100 is mandatory (ampoules are marked with labels with red text).

Diluted immunoglobulin is administered in a dose of 0.1 ml intradermally into the flexor surface of the forearm.

The test is considered negative if after 20 minutes the swelling or redness at the injection site is less than 1 cm. The test is considered positive if the swelling or redness reaches 1 cm or more.

If the reaction is negative, 0.7 ml of immunoglobulin diluted 1:100 is injected subcutaneously. If there is no reaction, after 30 minutes, the entire calculated dose of immunoglobulin, heated to (37±0.5) °C, is administered in 3 divided doses with an interval of 10-15 minutes, taking the drug for each portion from previously unopened ampoules.

If the intradermal test is positive (swelling or redness of 1 cm or more) or if an allergic reaction to the subcutaneous injection occurs, immunoglobulin is administered with special precautions.

When administering rabies immunoglobulin, solutions of adrenaline, ephedrine, diphenhydramine or suprastin should always be ready.

First, it is recommended to inject the drug diluted 1:100 into the subcutaneous tissue of the shoulder in doses of 0.5 ml, 2.0 ml, 5.0 ml with an interval of 15-20 minutes, then 0.1 ml of undiluted immunoglobulin. After 30-60 minutes, the entire prescribed dose of the drug, heated to (37±0.5) °C, is infiltrated around the wound or administered intramuscularly (depending on the nature of the damage) in 3 divided doses with an interval of 10-15 minutes.

Before the first injection, parenteral administration of antihistamines (suprastin, diphenhydramine, etc.) is recommended, and in order to prevent shock, before administering immunoglobulin, subcutaneous administration of an adrenaline solution is recommended
or norepinephrine in an age-specific dosage and 0.2-1.0 ml of ephedrine 5%.

To prevent complications of an allergic nature after the administration of immunoglobulin, it is necessary to prescribe orally antihistamines (suprastin, diphenhydramine, diprazil, fenkarol, etc.) in an age-specific dosage 2 times a day for 7-10 days.

If emergency prophylaxis of tetanus is necessary, it is carried out after the administration of rabies immunoglobulin and the first injection of rabies vaccine. To a victim who has received anti-tetanus serum within the next 24 hours, anti-rabies immunoglobulin is administered without prior intradermal testing. After the administration of rabies immunoglobulin, the patient must be under medical supervision for at least 1 hour. The vaccination performed is recorded in established registration forms indicating the dose, date, manufacturer of the drug, batch number, reaction to the administration.

Contraindications.

There are no contraindications. If there is a positive reaction to the administration of rabies immunoglobulin diluted 1:100, as well as
If the victim has a history of severe allergic reactions to the administration of antitetanus serum or other horse serum preparations, it is recommended that the administration of rabies immunoglobulin be carried out in a hospital environment equipped with resuscitation facilities.

Interaction with other drugs.

Interaction with other drugs has not been established.

Side effect.

Reaction to introduction. Injections of rabies immunoglobulin may be accompanied by the development of allergic reactions, including anaphylactic shock and serum sickness.

Release form.

Rabies immunoglobulin - 5 and 10 ml per ampoule; immunoglobulin diluted 1:100 - 1 ml per ampoule.

Available as a set: 1 ampoule of immunoglobulin and 1 ampoule of immunoglobulin diluted 1:100. 5 sets - in a cardboard box. The pack contains instructions for use and an ampoule knife.

Best before date.

Storage and transportation conditions. Shelf life - 1 year 6 months. After the expiration date, the drug cannot be used.

Storage.

In accordance with SP 3.3.2.1248-03, out of reach of children at a temperature of 2 to 8 °C.

Transportation.

In accordance with SP 3.3.2.1248-03, all types of covered transport at temperatures from 2 to 8 °C.

Vacation conditions.

For medical and preventive institutions.

Manufacturer. FGUZ RosNIPCHI "Microbe" Rospotrebnadzor, Saratov.

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Rabies vaccination preparations.

What is the choice of drugs based on?

For rabies vaccinations (rabies immunization), two drugs are used:

These drugs have different principles of action.

The rabies vaccine by itself is unable to kill the virus. The task of the vaccine is to provide the body with antigenic information about the virus. The immune system is provided with a non-living model of a real virus for familiarization, devoid of harmful force, but retaining its identifying marks - antigens.

By reading and remembering information about these identification marks, the immune system acquires the ability to produce specific proteins - antibodies. Antibodies recognize the virus by familiar antigens and neutralize it. With the help of a vaccine, so-called “active immunity” is acquired for a period of at least 1 year.

However, this process takes approximately two weeks. All this time, the body remains defenseless against the virus.

What to do? Provide temporary “crutches” - introduce ready-made antibodies.

Where can I get them from? In another organism. The drug containing concentrated antibodies is called “immunoglobulin” (the previously used drug, not purified from foreign protein fractions, was called “serum”). Immunoglobulin is obtained from donor blood. The donor can be a person (homologous immunoglobulin) or an animal, in practice a horse (heterologous immunoglobulin). To ensure that the donor has enough antibodies, he is pre-immunized with an anti-rabies vaccine. Human immunoglobulin is more effective than horse immunoglobulin, which is why the dose is administered at 2 times less. Plus it's safer.

Immunoglobulin, like any protein molecule, itself contains antigens. The more foreign the injected protein is, the more hostile the immune system perceives it. Within a few weeks after administration, immunoglobulin is completely destroyed in the body. This type of immunity is called "passive".

Thus, immunoglobulin provides passive immunity immediately, but for a short time, and the vaccine provides active immunity after two to three weeks, for a long time.

The choice of drugs mainly depends on the expected duration of the incubation period. Its duration is influenced primarily by the location of the bite, as well as the number, depth and extent of the bites.

If there is confidence that vaccinations will have time to create sufficient immunity before the onset of the disease (light bites), vaccinations are given

If it is impossible to wait until active immunity appears (severe and moderate bites, as well as delayed - more than 10 days - treatment for bites of any severity inflicted by an unknown or suspected animal with rabies), a combined course of treatment is carried out - in addition to the vaccine, they also administer

Rabies vaccine.

The first rabies vaccine was proposed in 1885 by Louis Pasteur. He obtained a weakened (called "fixed") strain of the virus by 90 successive passages of the virus through the brain of a rabbit. The Pasteur strain was provided different countries for the production of vaccines. Since then, a large number of vaccines have been developed. For a long time, live vaccines were used (containing live viruses of a fixed strain).

For rabies vaccinations, inactivated (i.e. containing a killed virus) vaccines, produced “in vitro” on tissue cultures, are now used.

Doses and vaccination schedules are the same for children and adults.

After the vaccine has dissolved, it should be used within no more than 5 minutes. The vaccine is administered intramuscularly into the deltoid muscle of the shoulder, and for children under 5 years old - into the upper part of the anterolateral surface of the thigh. Injection of the vaccine into the gluteal region is unacceptable.

The vaccinated person must be under medical supervision for at least 30 minutes.

Indications for vaccine administration:

Preventive immunization - people at high risk are vaccinated “just in case and in advance” - hunters, veterinarians, gamekeepers, employees of laboratories working with the “wild” rabies virus, etc.

Contraindications for preventive immunization:

acute infectious and non-infectious diseases, chronic diseases in the stage of exacerbation or decompensation - vaccinations are carried out no earlier than one month after recovery (remission)
local and systemic allergic reactions to the previous administration of the vaccine (generalized rash, angioedema, etc.)
pregnancy

Therapeutic and preventive immunization - carried out in connection with an already existing bite

There are no contraindications in this case.

Side effects of the vaccine:

local reactions - short-term swelling, redness, swelling, itching, hardening at the injection site
general reactions - moderate fever, tremors in the limbs, weakness, dizziness, headache, arthralgia (joint pain), myalgia (muscle pain), gastroenterological disorders (abdominal pain, vomiting)
possible development of immediate allergic reactions (urticaria, Quincke's edema)

Anti-rabies immunoglobulin.

Anti-rabies immunoglobulin is indicated for a combined course of immunization against rabies together with an anti-rabies vaccine:

in case of delayed treatment (more than 10 days) for bites of any severity inflicted by an unknown or suspected rabid animal

Two types of immunoglobulin are used:

heterologous (equine) immunoglobulin
homologous (human) immunoglobulin obtained from donor blood.

Homologous (human) rabies immunoglobulin is prescribed at a dose of 20 MO per 1 kg of body weight.
heterologous (equine) rabies immunoglobulin is prescribed at a dose of 40 MO per 1 kg of body weight.

Example: the patient’s body weight is 60 kg, the immunoglobulin activity is indicated on the package (for example, 200 IU in 1 ml)
60*40/200 = 12 ml should be administered to this patient after determining sensitivity to a foreign protein.

As much of the calculated dose as possible should be infiltrated near the wound and into the depth of the wound. If the anatomical location (fingertips, etc.) does not allow the entire dose of rabies immunoglobulin to be administered into the tissue near the wound, then the remainder is injected intramuscularly (into the upper thigh or into the deltoid muscle, on the side of the body opposite to the site of vaccine administration).

Administration of rabies immunoglobulin is most effective on the first day after the bite. The entire dose of the drug is administered in one day. Only in case of particularly wide and multiple bites inflicted by a rabid wolf or other carnivore, the administration of rabies immunoglobulin can be repeated, in the same dose, after which a course of vaccination is carried out with the obligatory administration of an additional dose of the vaccine on the 60th day from the start of treatment (see) .

Test for sensitivity to foreign protein.

20 minutes before the drug is administered, foreign protein sensitivity test- 0.1 ml of diluted (1:100) immunoglobulin is injected intradermally into the anterior surface of the forearm. An ampoule with diluted (1:100) immunoglobulin is attached to each dose of undiluted drug and is in the same package.

Diluted (1:100) immunoglobulin in a dose of 0.1 ml is injected intradermally into the anterior surface of the forearm.
after 20 minutes - sample evaluation ⇓
The test is negative if swelling or redness at the site of immunoglobulin injection does not exceed 1 cm The test is positive if there is swelling or redness of 1 cm or more at the site of immunoglobulin administration, or there is an allergic reaction
the test is negative ⇓		the test is positive ⇓
0.7 ml of diluted (1:100) immunoglobulin is injected subcutaneously to identify general sensitivity to a foreign protein.	if general reactions occur after 30 minutes ⇒	Injected diluted immunoglobulin (1:100) in doses of 0.5 ml, 2.0 ml, 5.0 ml is injected at intervals of 20 minutes into the subcutaneous tissue of the shoulder
in the absence of general reactions after 30 minutes ⇓		in 20 minutes ⇓
		0.1 ml of undiluted immunoglobulin is injected subcutaneously
		in 30-60 minutes ⇓
		Before the first injection of immunoglobulin, antihistamines (diphenhydramine, suprastin, etc.) are prescribed and are recommended to be taken orally for 10 days. In order to prevent shock, subcutaneous administration of a 0.1% solution of adrenaline or a 5% solution of ephedrine in an age-related dose is recommended.
		⇓
The entire dose of immunoglobulin, heated to 37°C, is administered in fractional doses (in 3 doses at intervals of 15 minutes), taking the drug for each portion from an unopened ampoule. The entire dose should be infiltrated around the wound and into its depth. If anatomical damage precludes this (fingertips, etc.), then the drug can be administered intramuscularly to other places (muscles of the buttock, thigh, shoulder, etc.). The entire dose is administered within an hour.

The drug contains rabies immunoglobulin , as well as additional components glycine glycocol as a stabilizer, water, sodium chloride. does not contain the product. It also does not contain antibodies to HIV, hepatitis C virus, or HBsAg.

Release form

Rabies immunoglobulin is produced in the form of an injection solution. It can be transparent or slightly opalescent. Colorless or light-colored liquid yellow color. The drug is packaged in bottles of 1, 2, 5 ml.

pharmachologic effect

Rabies immunoglobulin is a concentrated solution of purified gamma globulin fraction of whey. It is isolated from the blood using a cold ethanol extraction method. Next, the substance goes through an ultrafiltration process, it is purified and inactivated to ensure purification from viruses. The drug contains specific antibodies that can neutralize the virus .

Pharmacokinetics and pharmacodynamics

The highest level of antibodies in the blood is observed 2-3 days after the drug was administered to the patient intramuscularly. The half-life of antibodies is three to four weeks.

Indications for use

Rabies immunoglobulin is prescribed in combination with rabies vaccine to prevent the development of hydrophobia in people who have received multiple or severe bites from animals with rabies or those animals that are suspected of having rabies.

In case of repeated multiple bites of rabid or suspected rabid animals, the drug is not administered if after the first bite the patient has completed a full course of combined anti-rabies therapy. In this case, it is only necessary to prescribe the rabies vaccine.

Contraindications

Considering the fact that this drug is prescribed in the presence of vital signs. There are no contraindications to its use. People who are sensitive to human blood products, as well as pregnant women, should be administered immunoglobulin only in a hospital setting.

Side effects

Some people may develop hyperemia , appears swelling . Possible increase in body temperature to low-grade levels.

Very rarely, severe allergic reactions may develop:, manifestations,. Therefore, after administering the drug, a person must remain under the supervision of a specialist for at least thirty minutes.

Instructions for use (Method and dosage)

If a person has suffered from an animal bite, the surface of the wound should be treated immediately. It is recommended to wash the wounds and treat them with alcohol or rubbing alcohol. If necessary, the wound is treated surgically.

Next, specific therapy should be used. Before administration, the bottle containing Anti-Rabies Immunoglobulin must be carefully checked for integrity, determine whether it has the necessary markings, whether all physical properties solution.

The instructions for rabies immunoglobulin stipulate that the product is administered in strict compliance with all aseptic and antiseptic standards. There is no need to perform a skin test before administering the drug. It is advisable to administer the medicine as soon as possible after receiving a wound, and its dose is 20 IU per 1 kg of weight of an adult or child. The exact dose of the drug is calculated by the doctor immediately before administration.

Most of the dose should be infiltrated around the wound and into the depth of the wound. The rest of the drug is administered intramuscularly.

Adults receive an injection into the gluteal muscle; for children, the drug is injected into the anterolateral surface of the thigh.

If it is necessary to administer the drug to children, especially those who have multiple wounds, Rabies Immunoglobulin can be diluted with a 0.9% sodium chloride solution to a volume that will allow complete infiltration of the wounds. The drug must be administered no later than 7 days after the person has been in contact with an animal with rabies or suspected of having this disease.

Combination therapy must be carried out in such a way as to strictly adhere to a number of conditions. Initially, the patient needs to be administered Rabies Immunoglobulin, after which, after 30 minutes, an anti-rabies vaccine needs to be administered. This sequence of administration of these drugs must be strictly followed. Administration of immunoglobulin after rabies vaccine is not allowed.

The two drugs mentioned above must be injected into different parts of the body and use different syringes.

In no case should the dosage of immunoglobulin be exceeded, since if the dose is exceeded, the production of antibodies may be partially suppressed.

If the patient needs to be provided with emergency prophylaxis, it can be carried out only after rabies immunoglobulin has been administered and the first vaccination of rabies vaccine has been administered.

Overdose

There is no data on an overdose of the drug.

Interaction

Rabies immunoglobulin injection can be given at the same time as emergency tetanus prophylaxis. Other drugs can be administered only three months after the end of combination anti-rabies therapy.

Terms of sale

The drug is intended only for medical institutions.

Storage conditions

It is necessary to store and transport the product, maintaining a temperature of 2° to 8°C; the medicine should be protected from light and should not be frozen. Keep out of reach of children.

Best before date

Shelf life - 2 years.

special instructions

Rabies immunoglobulin should not be administered intravenously.

The solution should be used immediately after opening the bottle. The remaining solution cannot be used later.

The medicine should not be administered after the course of administration has been started. rabies vaccine .

If the patient has increased sensitivity to heterologous immunoglobulins and serums, then during the administration of the drug it is necessary to prescribe antihistamines medicines for 1 to 10 days. It is important to carefully monitor the person. Intravenous administration is contraindicated, so it is important to ensure during the injection process that the needle does not enter a blood vessel.

Before starting treatment, you should tell your doctor if you are taking any other medications.

For children

For children, the drug is prescribed according to indications and is administered in the dosage specified in the instructions into the anterolateral part of the thigh.

During pregnancy and lactation

It is practiced to administer the drug in the presence of vital indications.

ANTI-RABIC IMMUNOGLOBULIN FROM HORSE BLOOD SERUM LIQUID

Immunoglobulinum antirabicum ex sero eqvi fluidum

Rabies immunoglobulin from horse blood serum liquid (RAI) is a protein fraction of horse immune serum obtained by the rivanol-alcohol method.

Anti-rabies immunoglobulin is administered at a dose of 40 IU per 1 kg of body weight for an adult or child. Example: patient’s body weight is 60 kg, immunoglobulin activity (indicated on the package label), for example, 200 IU in 1 ml. In order to determine the dose of immunoglobulin required for administration, it is necessary to multiply the patient’s weight (60 kg) by 40 IU and divide the resulting number by the activity of the drug (200 IU), that is: 60x40/200 = 12 ml

Before administering rabies immunoglobulin to a patient, to determine sensitivity to a foreign protein, it is mandatory to perform an intradermal test with immunoglobulin diluted 1:100 (ampoules marked in red), which is located in a pack with undiluted drug (ampoules marked in blue).

Immunoglobulin diluted 1:100 in a dose of 0.1 ml is injected intradermally into the flexor surface of the forearm.

The test is considered negative if after 20-30 minutes the swelling or redness at the injection site is less than 1 cm. The test is considered positive if after 20 minutes the swelling or redness at the injection site reaches 1 cm or more.

If the reaction is negative, 0.7 ml of immunoglobulin diluted 1:100 is injected into the subcutaneous tissue of the shoulder. If there is no reaction, after 30 minutes, the entire calculated dose of immunoglobulin, heated to (37+0.5) °C, is administered in three divided doses with an interval of 10-15 minutes; the drug for each portion is taken from previously unopened ampoules.

The calculated dose of immunoglobulin should be infiltrated around the wounds and deep into the wound. If the anatomical location of the injury (fingertips, etc.) does not allow the entire dose to be administered around the wounds, then the remainder of the immunoglobulin is injected intramuscularly at sites other than the rabies vaccine (buttock muscles, upper thigh, forearm). The entire dose of rabies immunoglobulin is administered within 1 hour. In the case of a positive intradermal test (swelling or redness of 1 cm or more) or in the event of an allergic reaction to a subcutaneous injection, immunoglobulin is administered with extreme caution. First, it is recommended to inject the drug diluted 1:100 into the subcutaneous tissue of the shoulder in doses of 0.5 ml, 2.0 ml, 5.0 ml with an interval of 15-20 minutes, then 0.1 ml of undiluted immunoglobulin and after 30-60 minutes , - the entire prescribed dose of the drug, heated to (37?0.5) °C, is administered intramuscularly in three divided doses with an interval of 10-15 minutes. Before the first injection, parenteral administration of antihistamines (suprastin, diphenhydramine, etc.) is recommended. In order to prevent shock, simultaneously with the administration of immunoglobulin, subcutaneous administration of a 0.1% solution of adrenaline or a 5% solution of ephedrine in an age-specific dosage is recommended.

When administering rabies immunoglobulin, solutions of adrenaline, ephedrine, diphenhydramine or suprastin should always be ready.

To prevent complications of an allergic nature after the administration of immunoglobulin, it is necessary to prescribe orally antihistamines (suprastin, diphenhydramine, diprazine, fenkarol, etc.) in an age-specific dosage 2 times a day for 7 days.

To a patient who has received anti-tetanus serum within the next 24 hours, rabies immunoglobulin is administered without prior intradermal testing. After the administration of rabies immunoglobulin, the patient must be under medical supervision for at least 1 hour; the completed vaccination is recorded in established accounting forms indicating the date, the manufacturer of the drug, the batch number, and the reaction to the administration.

Anti-rabies immunoglobulin (RAI) is prescribed as soon as possible after contact with a rabid, suspected rabid or unknown animal, but no later than 3 days after contact. AIH is not used after administration of rabies vaccine (COCAV).

REACTION TO INTRODUCTION. Injection of rabies immunoglobulin may be accompanied by the development of allergic reactions, including anaphylactic shock and serum sickness.

CONTRAINDICATIONS. There are no contraindications. In the case of a sharply positive reaction to the administration of rabies immunoglobulin, as well as if the patient has a history of strong allergic reactions to the administration of antitetanus serum or other horse serum preparations, it is recommended that the administration of rabies immunoglobulin be carried out in a hospital environment equipped with intensive care facilities.

RELEASE FORM. Rabies immunoglobulin - in ampoules of 5 or 10 ml (ampoules marked in blue). Immunoglobulin, diluted 1:100 to determine human sensitivity to horse protein - in 1 ml ampoules, marked in red. Produced as a set: 1 ampoule of immunoglobulin and 1 ampoule of immunoglobulin, diluted 1:100.

PACKAGE. 5 sets in a cardboard box with included instructions for use and an ampoule knife.

CONDITIONS OF STORAGE AND TRANSPORTATION. Store in closed, dry, dark rooms at a temperature of (5?2) °C. Transport by all types of covered transport under conditions that exclude freezing and heating of the drug above 20 °C.

SHELF LIFE - 2 years.

Instructions for medical use

ANTI-RABIC CULTURAL VACCINES, CONCENTRATED, PURIFIED, INACTIVATED DRY

Anti-rabies vaccine cultural concentrated purified inactivated dry (KOKAV) is a vaccine rabies virus strain Vnukovo-32, grown in a primary culture of kidney cells of Syrian hamsters, inactivated by ultraviolet rays and formalin, concentrated and purified by methods: ultrafiltration with subsequent purification through porous silicas; ultracentrifugation or ion exchange chromatography. Stabilizers - gelato and sucrose. Porous mass white, hygroscopic. After dissolution, it is a slightly opalescent colorless liquid. One dose (1.0 ml) contains at least 2.5 International Units (IU).

IMMUNOLOGICAL PROPERTIES. The vaccine induces the development of immunity against rabies.

MODE OF APPLICATION. The contents of the vaccine ampoule must dissolve in 1.0 ml of water for injection within no more than 5 minutes. The dissolved vaccine is injected slowly intramuscularly into the deltoid muscle of the shoulder, for children under 5 years old - into the upper part of the anterolateral surface of the thigh. Injection of the vaccine into the gluteal region is not allowed. The drug is not suitable for use in ampoules with damaged integrity, labeling, as well as changes in color and transparency, expired or improperly stored. The opening of the ampoules and the vaccination procedure are carried out under strict adherence to the rules of asepsis. Storage of the dissolved vaccine for more than 5 minutes is not allowed.

The vaccinated person must be under medical supervision for at least 30 minutes. Vaccination sites must be equipped with anti-shock therapy. After a course of immunotherapy, a certificate is issued indicating the type and series of drugs, the course of vaccinations, and post-vaccination reactions.

Anti-rabies care consists of local treatment of wounds, scratches and abrasions, administration of rabies vaccine (COCAV) or the simultaneous use of rabies immunoglobulin (RAI) and rabies vaccine (COCAV).

PREVENTIVE IMMUNIZATION

INDICATIONS. For preventive purposes, people who perform work on catching and keeping stray animals are immunized; veterinarians, hunters, foresters, slaughterhouse workers, taxidermists; persons working with the “street” rabies virus.

Primary immunization Three injections on days 0, 7 and 30, 1.0 ml each

First revaccination after 1 year One injection, 1.0 ml

Subsequent revaccinations every 3 years One injection, 1.0 ml

CONTRAINDICATIONS FOR PREVENTIVE IMMUNIZATION:

1. Acute infectious and non-infectious diseases, chronic diseases in the stage of exacerbation or decompensation - vaccinations are carried out no earlier than one month after recovery (remission).

2. Systemic allergic reactions to previous administration of this drug (generalized rash, Quincke's edema, etc.).

4. Pregnancy.

TREATMENT AND PREVENTIVE IMMUNIZATION

1. There is no damage or salivation of the skin. No direct contact. Sick with rabies. Not assigned

2. Salivation of intact skin, abrasions, single superficial bites or scratches of the torso, upper and lower extremities (except for the head, face, neck, hand, fingers and toes, genitals), inflicted by domestic and farm animals If within 10 days of observation if the animal remains healthy, then treatment is stopped (i.e. after the 3rd injection). In all other cases, when it is impossible to monitor the animal (killed, died, ran away, disappeared, etc.) according to the following scheme. Start treatment immediately: KOKAV for 1.0 0, 3, 7, 14, 30 and 90 days

3. Any salivation of the mucous membranes, any bites of the head, face, neck, hand, fingers and toes, genitals; multiple bites and deep single bites of any localization, inflicted by domestic and farm animals. Any salivation and damage caused by wild carnivores, bats and rodents. In cases where it is possible to observe the animal and it remains healthy for 10 days, treatment is stopped (i.e. after the 3rd injection). In all other cases, when it is impossible to monitor the animal, continue treatment according to the specified regimen. Start combined treatment immediately and simultaneously: AIH on day 0 + COCAV 1.0 on days 0, 3, 7, 14, 30 and 90.

CONTRAINDICATIONS. None.

REACTION TO THE ADMINISTRATION OF ANTI-RABIOS DRUGS:

1. The introduction of the vaccine may be accompanied by a local or general reaction. The local reaction is characterized by slight swelling, redness, itching, and enlargement of regional lymph nodes. The general reaction can manifest itself in the form of malaise, headache, weakness, and increased body temperature. Symptomatic therapy and the use of hyposensitizing and antihistamines are recommended. In rare cases, neurological symptoms may be reported. In this case, the victim should be urgently hospitalized.

2. After administration of rabies immunoglobulin from horse serum, complications may be observed: anaphylactic shock, local allergic reaction that occurs 1-2 days after administration; serum sickness, which most often occurs on days 6-8. In the event of an anaphylactoid reaction, 0.3 to 1.0 ml of adrenaline (1:1000) or 0.2-1.0 ml of ephedrine 5% is injected into the subcutaneous tissue, depending on the age of the patient. When symptoms of serum sickness appear, parenteral administration of antihistamines, corticosteroids, and calcium supplements is recommended.

RELEASE FORM. The vaccine is produced in a set: 1 ampoule of vaccine, 1.0 ml (1 dose) and 1 ampoule of solvent (water for injection), 1.0 ml. The package contains 5 sets (5 ampoules with vaccine and 5 ampoules with solvent).

CONDITIONS OF STORAGE AND TRANSPORTATION. The vaccine is stored and transported at a temperature of 2 to 8°C. The vaccine can be transported at temperatures up to 25°C for no more than 2 days.

SHELF LIFE - 1.5 years.

In case of complications or a person's illness with hydrophobia after a full course of vaccinations or during its implementation, you should immediately inform the local health authority, the State Research Institute for Standardization and Control of Medical Biological Preparations named after. Ministry of Health of Russia [Moscow, Sivtsev Vrazhek lane, 41; ] and to the organization that manufactured the vaccine or immunoglobulin. The use of the vaccine series is delayed. Samples of the vaccine and AIH are sent to the State Research Institute named after...

In the event of the death of a vaccinated person, it is necessary to conduct a pathological-anatomical autopsy and laboratory diagnostic testing. To do this, pieces of the brain (horn of Ammon, brain stem, cerebellum, cerebral cortex) of a deceased person, extracted in compliance with the rules of asepsis, are placed in a sterile hermetically sealed vessel filled with a 50% aqueous solution of glycerin, cooled to minus 20 °C and then in a container with with ice, they are urgently sent to the appropriate diagnostic laboratory.

NOTES:

1. Doses and immunization schedules are the same for children and adults. A course of treatment with the vaccine is prescribed regardless of the time the victim seeks help, even several months after contact with a patient suspected of rabies or an unknown animal (except AIH).

2. For persons who have previously received a full course of therapeutic and prophylactic or preventive vaccinations, from the end of which no more than 1 year has passed, three injections of the vaccine, 1.0 ml each, are prescribed on days 0, 3, 7. If a year or more has passed, or an incomplete course of immunization has been completed, then - in the usual volume.

3. Corticosteroids and immunosuppressants may lead to vaccine failure. Therefore, in cases of vaccination while taking corticosteroids and immunosuppressants, determining the level of virus-neutralizing antibodies is mandatory. In the absence of virus-neutralizing antibodies, an additional course of treatment is carried out.

4. The person being vaccinated must know: he is prohibited from drinking any alcoholic beverages during the entire course of vaccinations and 6 months after its completion. You should also avoid overwork, hypothermia, and overheating.

Rabies immunoglobulin is a drug that is used to immunize the population against rabies.

About the drug

At its core, this drug is a solution of purified and concentrated gamma globulin fraction of serum. It is released from the blood. The cold ethanol extraction method is used. After this, so-called ultrafiltration is carried out, cleaning from viruses occurs. The drug contains special substances that can fight the common rabies virus, if such activity occurs.

After consuming immunoglobulin for approximately two to three days, highest level antibodies in the blood. Administration should be intramuscular. The half-life of antibodies is approximately a month or a slightly shorter period of time, depending on the characteristic nuances of the individual organism.

A little more valuable information about immunoglobulin:

Release form

The drug is traditionally available in the form of a solution intended for injection. It is predominantly transparent, although it can be slightly opalescent. It is packaged in bottles - 1, 2 or 5 ml.

Indications

The described drug is used in traditional combination with an anti-rabies vaccine, so that people who have been bitten by animals with rabies or, alternatively, with suspected rabies do not develop hydrophobia. If repeated bites occur, there is no need to re-administer the drug if the first treatment was successful. The rabies vaccine, which is used in combination therapy, should be reintroduced.

Contraindications

The drug in question has no significant contraindications; it can be administered to almost everyone. But if a person has a special sensitivity to human blood products, and also if the woman is pregnant, then the drug should be administered in a hospital, under the supervision of exclusively qualified doctors who can take prompt measures if necessary. But this does not mean that these people are prohibited from using this medicine in principle.

Side effects

Sometimes rabies immunoglobulin can cause certain side effects, but, however, not in all people. Often on the first day, hyperemia and swelling may appear. Sometimes body temperature rises. In very rare cases, a severe allergic reaction may occur, in particular:

anaphylactic shock;
hives;
Quincke's edema.

To minimize problems from side effects, it is necessary to remain under the supervision of a specialist for at least half an hour after administering the drug. Then the risk that any, even minimal complications will develop will be almost zero.

Application

The instructions for using the drug are not very complicated, but a number of subtleties must be taken into account. After a bite, you must first wash the surface of the wound. It is best to treat the wound with iodine solution or alcohol. If necessary, surgical treatment may be performed, depending on the severity of the bite. Next, you need to check the vial in which the vaccine is located for integrity, whether it is damaged, or whether the markings are missing.

The drug must be administered as quickly as possible after receiving the wound. The maximum you can wait if an animal has rabies, or there is the slightest suspicion of it, is seven days, no more. The dose is 20 IU per kilogram of a person’s weight, and it does not matter whether we are talking about a child or an adult. It is better to have a qualified doctor calculate the dose. Most of the dose is infiltrated both around the wound and into its depth. The rest must be administered to the person intramuscularly. If we are talking about an adult, what needs to be injected into the buttocks, a child can be injected into the thigh.

If a child has multiple wounds, you can dilute the drug with a solution of sodium chloride until the volume is reached at which the most complete infiltration of the wounds can be achieved.

Sometimes there is a need for combined treatment. Then this drug must be administered first, only then another rabies vaccine is introduced. On the contrary, you cannot do it, as the instructions say, otherwise there may be negative consequences. Moreover, these substances must be administered to different types of locations in the body.

Overdose

There is no information about the negative effects of an overdose of the drug, but another consequence can occur, which is also not very pleasant - partial suppression of antibody production in case of a noticeable excess of the dose. So you must try to comply with it.

Conclusion

When bitten by an animal that causes even the slightest suspicion of rabies, this drug is necessary. Moreover, it is very safe.

Side effects of rabies vaccination in humans Vaccination against rabies in humans prevents death

Rabies immunoglobulin from human blood serum is a drug from the group of immunological drugs.

Composition and release form

The drug is produced in a clear solution for injection; normally, the liquid can give a slight opalescence and is light yellow in color. The active substance is anti-rabies immunoglobulin in a dosage of 150 IU. Auxiliary compounds: stabilizer glycine glycocol, sodium chloride, in addition, water for injection.

The drug does not contain antibiotics, the drug does not contain HBsAg, antibodies to HIV-1, 2, as well as to the hepatitis C virus. The pharmaceutical industry supplies the drug in bottles of 1, 2 and 5 milliliters. Dispensing from pharmacies is carried out only to medical and preventive institutions.

Immunoglobulin is stored in cool conditions; the drug should not be frozen. The shelf life of the medicine is limited by time, it is two years, after which the drug will lose its qualities, and you should refrain from using it.

pharmachologic effect

Rabies immunoglobulin, made from human blood, is a concentrated gamma globulin fraction of serum isolated by the so-called cold extraction method using ethanol and subjected to ultrafiltration.

The drug contains specific antibodies that can neutralize the rabies virus. The maximum dose of antibodies is achieved after intramuscular injection of immunoglobulin after about three days. The half-life of antibodies can last for one month.

Indications for use

Immunoglobulin is prescribed in combination with rabies vaccine to prevent hydrophobia (fear of water) in case of multiple bites by rabid animals.

Contraindications for use

There are no contraindications to the use of immunoglobulin. In case of hypersensitivity to the drug, as well as during pregnancy, the medication is recommended for use in hospital settings.

Application and dosage

After a bite, it is necessary to immediately treat the wound, it is washed with water, after which 40-70% alcohol or a 5% iodine solution is used, and according to indications, primary surgical treatment of the wound surface is carried out. After local treatment, specific therapy begins. Check the integrity of the bottle with immunoglobulin and the presence of appropriate markings on it.

Opening the bottle, as well as the procedure for administering the drug itself, is carried out in compliance with asepsis and antisepsis. Usually, a skin test is not required before administering immunoglobulin. The dosage is 20 IU/kg body weight, it is administered intramuscularly and once.

Combined treatment with immunoglobulin is carried out, and thirty minutes later an anti-rabies vaccine is administered, this sequence must be strictly observed, and medications must be administered into different parts of the body, while separate syringes are required; mixing drugs is contraindicated.

The dosage of immunoglobulin should not be exceeded, since the use of an increased dose may suppress the production of antibodies.

Side effects

Anti-rabies immunoglobulin from human blood serum can cause an allergic reaction in some patients at the site of drug administration, which will manifest itself as swelling and redness of the tissues; in addition, a slight increase in temperature is possible. Usually local manifestations go away on their own and are not severe.

Sometimes allergic reactions to the drug develop quite rapidly and become systemic in nature, which is expressed in the addition of angioedema, and anaphylactic shock is also possible, therefore, patients who have received an injection of immunoglobulin should be under close medical supervision for half an hour so that, if necessary, it was timely to provide the patient with appropriate assistance.

special instructions

It is prohibited to administer Immunoglobulin intravenously. You cannot use the medication if a sediment forms that does not disappear during shaking; such a change in the physicochemical characteristics will indicate a change in the properties of the drug.

In addition, if there are cracks on the bottle with the drug, in the absence of appropriate labeling, as well as in a situation where the lid of the container does not close tightly, the use of the medication is contraindicated.

After opening a bottle of medicine, the drug must be used immediately, it cannot be stored, and the remaining part of the immunoglobulin must be disposed of in accordance with sanitary requirements.

Analogs

Rabies immunoglobulin, medicinal product Rebinolin, as well as Imogam Raj, are analogues.

Conclusion

We reviewed the product “Antirabies immunoglobulin from human blood serum”, instructions for use, application, indications, contraindications, action, side effects, analogues, its composition, dosage. Immunoglobulin must be administered in a medical facility, under the guidance of experienced medical personnel. If any allergic reaction occurs, the patient should promptly seek help from a competent doctor who will provide the necessary symptomatic measures.

Humanity lives on the planet in proximity to many forms of life, including microscopic ones. First of all, these are viruses and bacteria. Paradoxically, such tiny organisms have a huge impact on the human population.

Briefly about rabies

During the existence of the human species, many things have changed: climatic conditions, landscape, social formations, achievements in science, technology and medicine. It is thanks to the latter that people no longer die from the widespread pandemics that raged just a few centuries ago. But there remain a number of diseases that stubbornly cannot be cured, despite all the efforts made. Among them, rabies stands out especially clearly.

This disease has been known for a very long time. He changed many names, but the terrible essence of the disease remained unchanged - it is deadly. It is caused by (Rabies), which is carried by infected animals. The saliva that gets into the wound during a bite is filled with a viral component, and if you do not immediately contact it, the disease will very soon enter the active stage.

The name of the disease contains the word “demon” - it was the sick person who was considered possessed in ancient times. Symptoms of the disease appear on the tenth day. Sometimes the incubation period lasts up to several months and in very rare cases lasts for years. The essence of the disease is as follows: the virus affects the spinal cord and brain, causing photophobia, fear of water, aerophobia, hallucinations, paralysis and other severe disorders. In other words, a person is unable to drink a single sip of water, at the sight of which the patient immediately begins to have convulsions, and at the slightest movement of air the patient experiences sharp muscle spasms. Death occurs due to paralysis of the respiratory muscles and heart muscle.

Two ways of protection

Since the disease is extremely dangerous and almost 100% fatal, people have been trying to find ways to treat it or at least prevent it for centuries. At the end of the nineteenth century, the famous microbiologist Louis Pasteur, through many laboratory experiments on animals, invented a vaccine that helped stop the deadly journey of rabies across the planet.

Over time, scientists have found another way to help prevent the disease before the first symptoms appear. This is anti-rabies immunoglobulin. At the moment, these drugs are the only barrier to rabies. It should be noted that it is not capable of destroying the virus, like the second drug. Their operating principle is based on different mechanisms.

Distinctive features of anti-rabies drugs

So, what are the fundamental differences between these medications?

The effect of the rabies vaccine is based on the following scheme. After the drug is administered, viral antigens enter the body. This is a kind of neutralized analogue of a live virus, containing all the necessary information about it. It is required for the immune system to develop ways to adequately protect the body over a certain period of time (about 2 weeks). This occurs through the formation of specific proteins - antibodies. These substances remember everything related to the antigens of the specified virus, and when an aggressive agent enters the body, they immediately destroy it. Most vaccines work on this principle. Accordingly, active immunity is developed. This is why the rabies vaccine is used.

Rabies immunoglobulin acts somewhat differently. With its help, it is not dead viral antigens that enter the body, but donor antibodies. The fact is that while active immunity is being developed, the body is absolutely defenseless against the invasion of harmful microbes. Therefore, the patient is injected with rabies immunoglobulin, a drug based on donor blood from a person or animal (most often a horse). Thus, a large number of antibodies and antigens enter the body (the medication also contains them), which help to produce. The drug is mainly used as part of a combined course of immunization.

The difference between the described medications is that the vaccine provides more stable and long-lasting immunity, but after some time, and with the help of immunoglobulin, immediate but short-term protection of the body from the virus is produced.

Anti-rabies immunoglobulin: types

Depending on the origin of the antibodies, the drug is divided into two types:

Heterologous.
Homologous.

The first type is called “Anti-rabies immunoglobulin from horse.” The second is a medicine based on human donor blood. It is worth noting that to increase the amount of antibodies in the biological material, blood is taken from a person who has previously been vaccinated with an anti-rabies vaccine. This type of drug is considered more effective and safer than products of animal origin. The dosage of the homologous species required for immunization is half that.

Four names of such a drug as anti-rabies immunoglobulin are registered. There is more than one manufacturer for the product: two medications are manufactured in Russia (Biopharma, FSBI "ARRIAH"), the rest - in China (FC "Sichuan Yuanda Shuyang"), Israel ("Kamada Ltd.") and in Ukraine ("Biolek "). Considering the particular danger of the disease and the specific use of such drugs, they are sold directly - from pharmacies to medical institutions.

"Rebinolin" - anti-rabies immunoglobulin

The first type of this medication is based on human biomaterial. It is positioned by scientists as more effective. When considering its properties and application nuances, you should pay attention to the following points:

Dosage form. Anti-rabies immunoglobulin (the instructions clearly indicate this fact) is a transparent or slightly yellowish substance containing a slight sediment. This drug is in the form of a solution for administration into the body intramuscularly or subcutaneously.
Impact on the body. At least three days after administration, the maximum concentration of antibodies is achieved, aimed at destroying the rabies virus. These proteins are eliminated from the body over the course of a month.
Indications. Prescribed for contact with infected animals, involving bites and contact with saliva on the affected areas of the skin. The drug is administered in combination with an anti-rabies vaccine to mutually enhance the effect.
Undesirable manifestations. Since a foreign agent enters the body, the reaction can be very severe. In addition to redness, swelling and hyperthermia (sometimes only low-grade fever is observed), cases of sudden reactions have been recorded: Quincke's edema, urticaria or anaphylactic shock. Transient vomiting and hypotension were also noted.
Interaction with other medications. Incompatible with vaccines containing live viral cultures. Can be used in conjunction with antibiotics and
Special instructions. During pregnancy and lactation, the use of the drug is possible, since long-term study of the effect of immunoglobulins on human body allows us to assert that there is a harmful effect on the fetus and expectant mother the medicine will not have any effect.

Rabies immunoglobulin from human blood serum - effective remedy to prevent rabies. It should be emphasized that this drug has no contraindications, since it is prescribed from the point of view of life criteria. Moreover, the sooner the victim seeks help, the more stable the result will be.

Method of use of the drug

Before using rabies immunoglobulin, the instructions for use assume the following algorithm:

Thoroughly wash wounds with running water, soap and antiseptics.
Before administering the drug, check the integrity of the ampoule, appearance medication and expiration date.
Anti-rabies immunoglobulin (homologous) is administered taking into account this dosage: 20 IU per kilogram of human weight.
It is better if almost the entire dose is injected directly into the wound or nearby affected tissue. If this action is not possible, an intramuscular injection is performed in full.
For children, the drug is injected into the thigh area, for adults - into the buttock.

A product called “Rebinolin” is of Israeli origin. The shelf life of the drug, subject to storage conditions, is 2 years. Freezing immunoglobulin is strictly prohibited. Permissible storage temperature is from 2 to 8 ⁰С.

A complex approach

As a rule, immunoglobulin of any kind is administered along with the rabies vaccine. In this regard, there are several points that you should definitely pay attention to:

The administration of rabies immunoglobulin is carried out strictly before using the vaccine (the break between drugs is 30 minutes).
To use the products, different parts of the body are selected, located as far as possible from each other. For example, immunoglobulin - into the left buttock, and the vaccine - into the deltoid muscle on the right.
Syringes for medications must be different.
The medication is not administered intravenously.
It is strictly not recommended to increase the dosage of rabies immunoglobulin.

Preparation based on animal biomaterial

“Antirabies immunoglobulin from horse blood serum” (liquid) is classified as a heterologous species. It is considered slightly less safe for the reason that the specific proteins it contains can cause an unpredictable reaction in the body. At the same time, the use of a drug based on human biomaterial is relatively well tolerated by patients. In this regard, before using heterologous immunoglobulin, an intradermal test is mandatory in the forearm area.

If after 20 minutes there is no serious swelling or redness, then diluted immunoglobulin (1 to 100 solution) is administered subcutaneously. And only if after half an hour the test is still negative, use the rest of the drug. And not immediately, but according to the following scheme: part of the heated dose of rabies immunoglobulin is injected into the wound area, after 15 minutes the next portion is injected into the tissue around the wound. If the anatomical features of the bite site do not allow the use of the entire ampoule in the affected area, then the rest is used for intramuscular injection. The whole procedure lasts about an hour.

If heterologous anti-rabies immunoglobulin is used for immunization, the instructions state that if there is a positive test, antihistamines are prescribed before administering the drug, and an adrenaline solution is used to avoid shock.

Another difference between this type and the previous one is the dosage. A product based on horse blood serum is used in a twice as high dose (40 IU per kilogram of body weight).

Rabies vaccine

Currently on site Russian Federation 5 domestically produced drugs and one Indian drug are registered. This vaccine is produced in transparent ampoules complete with distilled water and contains inactivated rabies virus. After dilution, it appears as a pink or colorless liquid. Using this tool There are important nuances:

When administered, the necessary antiseptic rules must be observed, and the vaccination room must be equipped with anti-shock agents and drugs to provide emergency care. After dilution, the rabies vaccine can be stored for no more than 5 minutes.
Half an hour after the homologous immunoglobulin has been administered, the use of the vaccine is permitted.
The drug is injected into the thigh area (children under 5 years old) or into the deltoid muscle of the shoulder girdle. The use of the drug in the buttock area is strictly prohibited.
The patient should be under the supervision of medical staff for at least half an hour after the procedure.

Types of immunization

There are two types of immunization: preventive and curative. The first is used if a person is engaged in potentially dangerous activities where there is a high risk of contracting rabies. These are hunters, rangers, workers in bacteriological laboratories, and veterinarians. The second type is applied directly after contact with a sick animal. Both options have a specific execution algorithm. In addition to the schemes, there is one more difference between these types. If in the first case a contraindication may be a chronic disease in the acute stage or pregnancy, then the second type of immunization is carried out according to vital indications.

Vaccination schedules

The generally accepted vaccination schedule is as follows:

If the nature of the contact involves minor damage to the skin - scratches, minor bites, abrasions, as well as salivation by pets, and all of these wounds are in the area of the torso and limbs, then the person is vaccinated immediately after treatment of the injuries. A single dose of rabies vaccine is 1 ml. Immunization is carried out on the day of contact, and then on the 3rd, 7th, 14th, 30th and 90th day. The scheme can be changed if the animal under observation did not die or the rabies virus was not detected. In this case, they are limited to three doses of the vaccine.
Any wounds to the head, neck, hands, genitals, ankles and fingers caused by domestic animals, as well as injuries or salivation received from wild animals, rodents and bats, require immediate comprehensive measures. On the day of contact, before the administration of the rabies vaccine, a mandatory injection of immunoglobulin is used, carried out in accordance with the above rules. Next, immunization is carried out according to the standard scheme.

According to vital indications

This phrase is often heard in doctors' offices or on hospital wards, so everyone is used to it. But unfortunately, people sometimes tend to forget how valuable human life is. Every day, seeing your child’s smile, hearing your mother’s voice on the phone, watching birds fly - all this is so ordinary that it is taken for granted. And only when trouble comes knocking on the door do people remember this. Take care of yourself and your loved ones, and in case of potential danger, do not delay seeking help.

Release form

Rabies immunoglobulin is produced in the form of an injection solution. It can be transparent or slightly opalescent. The liquid is colorless or light yellow. The drug is packaged in bottles of 1, 2, 5 ml.

pharmachologic effect

Pharmacokinetics and pharmacodynamics

The highest level of antibodies in the blood is observed 2-3 days after the drug was administered to the patient intramuscularly. The half-life of antibodies is three to four weeks.

Indications for use

Contraindications

Side effects

Some people may develop hyperemia , appears swelling . Possible increase in body temperature to low-grade levels.

Very rarely, severe allergic reactions may develop: , manifestations , . Therefore, after administering the drug, a person must remain under the supervision of a specialist for at least thirty minutes.

Instructions for use (Method and dosage)

Most of the dose should be infiltrated around the wound and into the depth of the wound. The rest of the drug is administered intramuscularly.

Adults receive an injection into the gluteal muscle; for children, the drug is injected into the anterolateral surface of the thigh.

The two drugs mentioned above must be injected into different parts of the body and use different syringes.

In no case should the dosage of immunoglobulin be exceeded, since if the dose is exceeded, the production of antibodies may be partially suppressed.

If the patient needs emergency prophylaxis, then it can be carried out only after rabies immunoglobulin has been administered and the first vaccination of rabies vaccine has been administered.

Overdose

There is no data on an overdose of the drug.

Interaction

Rabies immunoglobulin injection can be given at the same time as emergency tetanus prophylaxis. Other drugs can be administered only three months after the end of combination anti-rabies therapy.

Terms of sale

The drug is intended only for medical institutions.

Storage conditions

It is necessary to store and transport the product, maintaining a temperature of 2° to 8°C; the medicine should be protected from light and should not be frozen. Keep out of reach of children.

Best before date

Shelf life - 2 years.

special instructions

Rabies immunoglobulin should not be administered intravenously.

The solution should be used immediately after opening the bottle. The remaining solution cannot be used later.

The medicine should not be administered after the course of administration has been started. rabies vaccine .

If the patient has increased sensitivity to heterologous immunoglobulins and serums, then during the administration of the drug it is necessary to prescribe antihistamines for 1 to 10 days. It is important to carefully monitor the person. Intravenous administration is contraindicated, so it is important to ensure during the injection process that the needle does not enter a blood vessel.

Before starting treatment, you should tell your doctor if you are taking any other medications.

For children

For children, the drug is prescribed according to indications and is administered in the dosage specified in the instructions into the anterolateral part of the thigh.

During pregnancy and lactation

It is practiced to administer the drug in the presence of vital indications.