Rabix-IG Injection

Rabix-IG Injection (Rabies Immunoglobulin 1000 IU/5ml)

Manufacturer: Incepta Pharmaceuticals Ltd.
Generic Name: Rabies Immunoglobulin (Human)
Therapeutic Class: Immunoglobulins / Passive Immunisation Agents
Strength: 1000 IU per 5ml vial
Price: ৳1,000.00 per vial

Indications

Rabix-IG is indicated for post-exposure prophylaxis (PEP) of rabies in individuals who have not been previously immunised against rabies. It is used in combination with rabies vaccine as part of the complete post-exposure prophylaxis regimen following exposure to a potentially rabid animal (bite, scratch, or mucous membrane contamination). Rabix-IG provides immediate, passive immunity while the patient develops active immunity through vaccination.

Composition

Each vial contains: Rabies Immunoglobulin (Human) 1000 IU in 5ml (200 IU/ml). Prepared from pooled plasma of hyperimmunised human donors with high titres of anti-rabies antibodies.

Mechanism of Action

Rabix-IG provides passive immunisation by supplying pre-formed anti-rabies antibodies (IgG) that immediately neutralise the rabies virus at the wound site and in circulation. These antibodies bridge the critical gap between exposure and the development of active immunity from the rabies vaccine (which takes approximately 7–14 days). The product is manufactured and standardised to contain a minimum of 150 IU/ml of anti-rabies antibody.

Dosage and Administration

Dose: 20 IU/kg body weight (single dose).

Route: The full calculated dose should be infiltrated into and around all wound(s) as thoroughly as possible. If the volume of RIG is insufficient to infiltrate all wounds (especially multiple wounds), it may be diluted with normal saline (up to 2–3 times) to ensure complete wound infiltration. Any remaining volume after wound infiltration should be administered intramuscularly (IM) at a site distant from the rabies vaccine injection site.

Timing: Must be administered on Day 0 (the same day as the first dose of rabies vaccine, or within 7 days of commencing the vaccine series). Rabix-IG must NOT be given after the 7th day of the vaccine series, as active antibody production will have commenced.

Rabies Vaccine Co-administration: Administer rabies vaccine simultaneously at a different anatomical site using a separate syringe. Never mix with the vaccine in the same syringe.

Contraindications

• Known severe hypersensitivity (anaphylaxis) to human immunoglobulin preparations or any excipient
• IgA deficiency with antibodies against IgA (use with extreme caution — risk of anaphylaxis)
• Previously immunised individuals (complete pre-exposure or post-exposure vaccination) — Rabix-IG is NOT indicated; only booster vaccine doses are required

Warnings and Precautions

• Administer under medical supervision with facilities for the management of anaphylaxis (adrenaline 1:1000 must be immediately available).
• Do not administer intravenously (IV) — IM or intralesional infiltration only.
• As a blood-derived product, the risk of transmitting infectious agents (including viruses) cannot be entirely excluded, despite rigorous donor screening and viral inactivation processes.
• Patients with IgA deficiency may have antibodies to IgA and are at risk of severe hypersensitivity reactions.
• Immunoglobulin administration may interfere with the immune response to live vaccines (e.g., MMR, varicella) — defer live vaccines for at least 3 months after administration.
• May interfere with certain serological tests for a period after administration.

Side Effects

Local (at injection/infiltration site): Pain, tenderness, redness, swelling — common and expected.

Systemic (uncommon): Low-grade fever, malaise, headache, myalgia.

Rare but serious: Anaphylaxis, angioedema, hypotension — requires immediate treatment with adrenaline and supportive care.

Drug Interactions

• Rabies vaccine: Administer at a separate anatomical site; do not mix. Rabix-IG does not reduce vaccine efficacy when administered correctly.
• Live attenuated vaccines (MMR, varicella, yellow fever): Defer for at least 3 months post-Rabix-IG administration as passively transferred antibodies may inhibit immune response.
• Anticoagulants: IM injections carry risk of haematoma in patients on anticoagulation — use with caution.

Use in Special Populations

Pregnancy: Post-exposure rabies prophylaxis is not contraindicated in pregnancy. The risk of rabies is invariably fatal if untreated; benefits of PEP (including Rabix-IG) far outweigh any theoretical risk to the foetus.

Lactation: May be used during breastfeeding; passive antibodies passed to infant through breast milk are not harmful.

Paediatrics: Dose is weight-based (20 IU/kg); safe for use in children of all ages.

Elderly: No dose adjustment required.

Storage

Store at 2°C to 8°C (refrigerated). Do not freeze. Protect from light. Once opened, use immediately — discard any unused portion. Keep out of reach of children. Do not use after the expiry date printed on the vial.

Pricing

Rabix-IG Injection 1000 IU/5ml: ৳1,000.00 per vial

Disclaimer: This product information is for reference purposes only and does not substitute professional medical advice, diagnosis, or treatment. Always consult a registered physician or qualified healthcare professional before taking any medication.