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Rabies Vaccine, Inactivated

Rabies vaccineViral vaccine

Indications

Registered South African indications:

  • Pre-exposure rabies immunisation
  • Post-exposure rabies prophylaxis

Cautions

Contraindications

Pre-exposure prophylaxis 

  • Severe hypersensitivity to the active ingredient or any of the excipients
  • Acute diseases requiring treatment should not be vaccinated until at least 2 weeks after recovery

Post-exposure prophylaxis 

  • No contraindications

Cautions

  • Pregnancy
  • Breastfeeding

Adult dosage

Forms avail. in SA and covered in this monograph: inj

Rabies pre-exposure prophylaxis - Primary immunisation

  • IM: 3 doses: 1ml given on days 0, 7 and 21 OR 28

Booster immunisation given to individuals previously immunised who remain at risk

  • IM: 1ml as single dose, 2 years after last dose

Rabies post exposure prophylaxis
-Patients not previously immunised

  • IM: 5 doses: 1ml given on day 0, 3, 7, 14 and 28

 Post-exposure immunisation should begin as soon as possible after exposure

Rabies vaccine needs to be preceeded by Human Rabies Immunoglobulin (HRIG)

Rabies post exposure prophylaxis
-Patients previously completed immunisation regimens with a cell culture vaccine
-Patients immunised with other types of vaccines and who have documented rabies antibody titres

  • IM: 2 doses: 1ml on day 0 and 3
Category of exposure Type of exposure to a domestic or wild animal suspected or confirmed to be rabid, or animal unavailable for testing Recommended post-exposure prophylaxis
I Touching or feeding of animals

Licks on intact skin

Contact of intact skin with secretions or excretions of a rabid animal or human case		 None, if reliable case history is available.
 
II Nibbling of uncovered skin

Minor scratches or abrasions without bleeding
 		 Administer vaccine immediately

Stop treatment if animal remains healthy throughout an observation period of 10 days or is proven to be negative for rabies by reliable laboratory using appropriate diagnostic techniques
III Single or multiple transdermal bites or scratches, licks on broken skin

Contamination of mucous membrane with saliva (i. e. licks)

Exposure to bats
 		 Administer rabies vaccine immediately, and rabies immunoglobulin, preferably as soon as possible after initiation of post-exposure prophylaxis. Rabies immunoglobulin can be injected up to 7 days after first vaccine dose administration.

Stop treatment if animal remains healthy throughout an observation period of 10 days or is proven to be negative for rabies by reliable laboratory using appropriate diagnostic techniques

Rabies immunoglobulin is not indicated

See additional prescribing points for administration directions

DO NOT administer IV, SC or intragluteal

Paediatric dosage

See adult dosage

Special populations

Pregnancy 

  • Caution
  • No cases of harm attributable to use of rabies vaccine during pregnancy have been observed. Rabies vaccine may be administered to pregnant women when post-exposure prophylaxis is required. The vaccine may also be used for pre-exposure prophylaxis during pregnancy if it is considered that the potential benefit outweighs any possible risk to the foetus

Breastfeeding

  • Caution
  • While it is not known whether rabies vaccine enters breast milk, no risk to the breastfeeding infant has been identified. Rabies vaccine may be administered to breastfeeding women when post-exposure prophylaxis is required. The vaccine may also be used for pre-exposure prophylaxis in breastfeeding women if it is considered that the potential benefit outweighs any possible risk to the infant

Renal Impairment

Hepatic Impairment

Elderly

Porphyria Information

Drugs in Sport

  • Permitted - No warnings

Adverse reactions

Central Nervous System Disorders

  • Headache
  • Dizziness
  • Paraesthesia
  • Encephalitis
  • Guillain-Barré syndrome
  • Pre-syncope
  • Syncope
  • Vertigo
  • Asthenia

Gastrointestinal Disorders

  • Nausea and vomiting
  • Diarrhoea
  • Abdominal pain or discomfort

Endocrine and Metabolic Disorders

  • Decreased appetite

Musculoskeletal Disorders

  • Myalgia
  • Arthralgia

Skin and Subcutaneous Tissue Disorders

  • Rash
  • Urticaria
  • Hyperhydrosis 
  • Angioedema
  • Injection site reactions

Immune, Blood and Lymphatic System Disorders

  • Lymphadenopathy
  • Hypersensitivity
  • Anaphylaxis
  • Fever

Interactions

Immunosuppressants

Monitoring

None routine. Specific cases may require

  • Antibody titer

Prescribing points

Administration Directions

  • Adults and children ≥ 2 years of age: Admin. IM into the deltoid
  • Children < 2 years: Admin. IM into the anterolateral area of the thigh
  • DO NOT administer IV, SC or intragluteal

Mechanism of action

Rabies vaccine is an inactivated viral vaccine which promotes immunity by inducing an active immune response.

Dosage forms

  • Vaccine

Formulation

Injection (per 1ml) 2.5iu

  • Chirorab (Kahma Biotech)
  • Rabipor (Litha) originator

Injection (per 0.5ml) 2.5iu

  • Verorab (Sanofi)

References

1. SAMF_12th Edition_Page 366 2. SmPC: Rabipur Ampoule, GlaxoSmithKline UK: Last updated on eMC: 07 Jun 2018; Downloaded online; 25 Jul 2018 https://www.medicines.org.uk/emc/medicine/14933 3. mobimims rabipor 4. https://drive.google.com/drive/folders/1mdIn1RbH93qm9Gnwmr-C0YOyFdTQT7VC (7/2013_Sanofi_Verorab_vac) 5. U2D: Rabies virus vaccine: Drug information; Uptodate; Downloaded online; 30 Oct 2018 https://www.uptodate.com/contents/rabies-virus-vaccine-drug-information?search=rabies%20vaccine&source=panel_search_result&selectedTitle=1~50&usage_type=panel&kp_tab=drug_general&display_rank=1 6. NAPOS The Drug Database for Acute Porphyria: Rabies vaccine; Accessed online 30 Oct 2018 http://www.drugs-porphyria.org/languages/UnitedKingdom/s3.php?atc_code=J07BG01&l=gbr 7. South African Institute for Drug-Free Sport; Verorab; Accessed online 30 Oct 2018 [http://www.drugfreesport.org.za/online-medication-check/]

Brands & products

3 products · cached snapshot
Trade names (3)
  • Chirorab
  • Rabipor
  • Verorab

VACVaccine· 3 products

from R417.75
ProductStrengthPackApplicantMin price
Rabies Vaccine Cipla2.5 iu/ml1Cipla Medpro (Pty) LtdR417.75
Chirorab2.5 iu/ml1Kahma Biotech (Pty) LtdR435.86
Verorab2.5 iu/0.5ml0.5Sanofi Aventis South Africa (Pty) LtdR568.23

Medical aid coverage

data not yet integrated
Discovery Health
not yet integrated
  • Comprehensive Series—
  • Executive Plan—
  • KeyCare Series—
  • Priority Series—
  • Saver Series—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

Bonitas Medical Fund
not yet integrated
  • BonClassic—
  • BonComprehensive—
  • BonEssential—
  • BonFit Select—
  • BonSave—
  • BonStart—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

GEMS — Government Employees Medical Scheme
not yet integrated
  • Beryl—
  • Emerald—
  • Onyx—
  • Ruby—
  • Sapphire—
  • Tanzanite One—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

POLMED — Police Medical Aid Scheme
not yet integrated
  • Aquarium Option—
  • Efficiency Option—
  • Marine Option—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

NeoHealth® ID 14751 · updated 2/3/2026