Rabies immunoglobulin

Rabies immunoglobulin (RIG) is a medication made up of antibodies against the rabies virus.[1] It is used to prevent rabies following exposure.[1] It is given after the wound is cleaned with soap and water or povidone-iodine and is followed by a course of rabies vaccine.[1] 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.[1] It works by binding to the rabies virus before it can enter nerve tissue.[1] 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 became common within medicine in the 1950s.[5] It is on the World Health Organization's List of Essential Medicines, the safest and most effective 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 US$1,000.00 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]