Kedrab (Intramuscular)

Rabies immune globulin is used along with the rabies vaccine to prevent infection from the rabies virus. It helps your body by providing antibodies that protect against the rabies virus. This is known as passive protection. This passive protection lasts long enough for your body to start making its own antibodies against the rabies virus.

Rabies immune globulin is given to people who have been exposed (for example, through a bite, scratch, or lick) to an animal that is known or suspected to have rabies. This is referred to as post-exposure prophylaxis. Rabies immune globulin is used only in individuals who have never received the rabies vaccine before.

Rabies infection is serious and often deadly. In the U.S., rabies in wild animals, especially raccoons, skunks, and bats, is the main source of rabies transmitted to humans, pets, and other domestic animals. In Canada, the animals most frequently infected with rabies include foxes, skunks, bats, dogs, and cats. Horses, swine, and cattle can also become infected with rabies. In many other parts of the world, including Latin America, Africa, and Asia, dogs are the primary carriers of rabies that infect humans.

If you are receiving (or will be receiving) treatment for a potential rabies infection while traveling outside of the U.S. or Canada, contact your doctor as soon as you return to the U.S. or Canada, as you may need additional treatment.

This medicine is to be given only by or under the supervision of your doctor or another health care professional.

It is very important that your doctor checks you closely to ensure this medicine is working properly. Blood tests are needed to monitor for unwanted effects.

This medicine is made from donated human blood. Some human blood products have transmitted certain viruses to people who have received them, although the risk is low. Human donors and donated blood are both tested for viruses to keep the transmission risk low. Talk with your doctor if you have concerns about this risk.

While you are being treated with rabies immune globulin, do not have any immunizations (vaccinations) without your doctor's approval. You should not receive the measles vaccine within 4 months after receiving rabies immune globulin. You should also not receive other live virus vaccines (e.g., mumps, polio, rubella) within 3 months after receiving this medicine.

This medicine may cause serious allergic reactions, including anaphylaxis. This can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

This medicine may increase your risk of developing blood problems, including blood clots or hemolysis (breakdown of red blood cells). Check with your doctor right away if you have swelling and pain in your arms, legs, or stomach, chest pain, shortness of breath, loss of sensation, confusion, problems with muscle control or speech, stomach or back pain, dark urine, decreased urination, fever, tiredness, or yellow eyes or skin.

In deciding to use a medicine, you need to balance the risks of taking it against the benefits it may provide. This is a decision you will make with your doctor. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

There have not been appropriate studies done on how rabies immune globulin affects children. Safety and effectiveness have not been established.

Geriatric

There is no information available on how HyperRAB® affects older patients.

Studies to date have not shown any specific problems in elderly patients that would limit the usefulness of KedRAB®.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication while breastfeeding. Weigh the potential benefits against the potential risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if there may be an interaction. In these situations, your doctor may want to adjust the dose or take other precautions. When receiving this medicine, it is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been chosen due to their potential importance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both might be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both of the medicines.

• Adenovirus Vaccine
• Dengue Tetravalent Vaccine, Live
• Influenza Virus Vaccine, Live
• Measles Virus Vaccine, Live
• Mumps Virus Vaccine, Live
• Poliovirus Vaccine, Live
• Rotavirus Vaccine, Live
• Rubella Virus Vaccine, Live
• Smallpox Vaccine
• Varicella Virus Vaccine, Live
• Yellow Fever Vaccine
• Zoster Vaccine, Live

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used around the time of eating food or certain types of food because interactions may happen. Using alcohol or tobacco with some medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect your use of this medicine. Be sure to tell your doctor if you have any other medical problems, especially:

• Bleeding disorders or
• Thrombocytopenia (low number of platelets)—Use with caution. May worsen these conditions.

• Blood clotting problems, or history of or
• Heart and blood vessel problems, or history of or
• High cholesterol or fats in the blood or
• Hyperviscosity syndrome (increased thickness of the blood) or
• Patients needing to stay inactive for a long time—Use with caution. May increase the risk of developing thrombosis (blood clots).

• Immunoglobulin A (IgA) deficiencies—Rabies immune globulin may cause an allergic reaction.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may occur, but if they do, they might need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

• Body aches or pain
• chills
• cough
• difficulty in breathing
• ear congestion
• fever
• headache
• loss of voice
• nasal congestion
• runny nose
• sneezing
• sore throat
• unusual tiredness or weakness

Rare

• Cloudy or bloody urine
• high blood pressure
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• swelling of the face, feet, or lower legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

More common

• Dizziness
• joint pain
• muscle pain
• pain, soreness, tenderness, or stiffness at the injection site

Less common

• Fever

Rare

• Skin rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Bayrab
• HyperRAB S/D
• Imogam Rabies-HT
• Kedrab

Available Dosage Forms:

• Solution

Therapeutic Class: Immune Serum

A doctor, nurse, or other trained health professional will give you this medicine in a hospital or clinic. It is given as a shot in the upper arm (deltoid) or thigh muscle. It may also be injected directly into the body part that was bitten or scratched which caused your exposure to rabies.

This medicine is given together with your first rabies vaccine dose as soon as possible after exposure. It may also be given within 7 days after the first dose of the rabies vaccine.

All bite wounds and scratches should be cleaned well right away with soap and water. Other medicines (including povidone-iodine solution, anti-tetanus vaccine, or medicine to treat infection) should be given as directed by your doctor.