Rabies immunoglobulin

Rabies immunoglobulin (RIG) is a medication made up of antibodies against the rabies virus. It is used to prevent rabies following exposure. It is given after the wound is cleaned with soap and water or providone-iodine and is followed by a course of rabies vaccine. It is given by injection into the site of the wound and into a muscle.^[1] It is not needed in people who have been previously vaccinated against rabies.^[2]

Common side effects include pain at the site of injection, fever, and headache.^[1] Severe allergic reactions such as anaphylaxis may rarely occur.^[3] Use during pregnancy is not known to harm the baby. It works by binding to the rabies virus before it can enter nerve tissue. After the virus has entered the central nervous system, rabies immunoglobulin is no longer useful.^[1]

The use of rabies immunoglobulin in the form of blood serum dates from 1891.^[4] Use become common within medicine in the 1950s.^[5] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.^[6] Rabies immunoglobulin is expensive and hard to come by in the developing world.^[7] In the United States it is estimated to be more than 1,000.00 USD per dose.^[8] It is made from the blood plasma of people or horses who have high levels of the antibody in their blood.^[1][8] The horse version is less expensive but has a higher rate of side effects.^[8][5]

References

1. 1 2 3 4 "Rabies Immune Globulin". The American Society of Health-System Pharmacists. Retrieved 8 January 2017. 
2. ↑ WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 398. ISBN 9789241547659. Retrieved 8 January 2017. 
3. ↑ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 869. ISBN 9780857111562. 
4. ↑ Plotkin, [edited by] Stanley A.; Orenstein,, Walter A.; Offit, Paul A. (2013). Vaccines (6th ed.). [Edinburgh]: Elsevier/Saunders. p. 659. ISBN 1455700908. CS1 maint: Extra text: authors list (link)
5. 1 2 Jong, Elaine C.; Zuckerman, Jane N. (2004). Travelers' Vaccines. PMPH-USA. p. 205. ISBN 9781550092257. 
6. ↑ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Retrieved 8 December 2016. 
7. ↑ Tintinalli, Judith E. (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)) (7 ed.). New York: McGraw-Hill Companies. p. 1054. ISBN 0-07-148480-9. 
8. 1 2 3 Research Advances in Rabies. Academic Press. 2011. p. 351. ISBN 9780123870414.