Verorab

Uses

What is verorab used for?

Verorab is commonly used for prevention of rabies in children and adults. It can be used before or after exposure, as a primary vaccination or as a booster dose.

How should I take verorab?

Verorab is administered IM route into the deltoid area in adults or the anterolateral aspect of the thigh in infants and toddlers by the doctor. In some countries, the intradermal injection may be used as an alternative, on upper or forearm.

How do I store verorab?

• Store in the refrigerator (2-8°C). Do not freeze.
• Vaccine may be used up to 8 hours after reconstitution provided it is maintained at 2-8°C. Unused vaccine must be discarded after 8 hours.
• Any unused product or waste should be disposed of in accordance with the regulations in effect.

Precautions & warnings

What should I know before using verorab?

• In subjects with a history of allergy there may be an increased risk of side-effects and this possibility should be taken into account.
• As with all vaccines, appropriate facilities and medication such as epinephrine (adrenaline) should be readily available for immediate use in case of anaphylaxis or hypersensitivity following injection.
• The vaccine may contain traces of neomycin and betapropiolactone which are used during the manufacturing process. Caution must be exercised when the vaccine is administered to subjects with hypersensitivity to betapropiolactone, neomycin, and other antibiotics of the same class.
• If rabies immunoglobulin is indicated in addition to rabies vaccine BP, then it must be administered at a different anatomical site to the vaccination site.
• Rabies vaccine BP should not be administered to patients with bleeding disorders such as haemophilia or thrombocytopenia, or to persons on anticoagulant therapy unless the potential benefit clearly outweighs the risk of administration. If the decision is taken to administer rabies vaccine BP in such persons, it should be given with caution with steps taken to avoid the risk of haematoma formation following injection.
• The potential risk of apnea and the need for respiratory monitoring for 48-72 h should be considered when administering the primary immunization series to very premature infants (born ≤ 28 weeks of gestation) and particularly for those with a previous history of respiratory immaturity. As the benefit of vaccination is high in this group of infants, vaccination should not be withheld or delayed.

Is it safe during pregnancy or breastfeeding?

Pregnancy:

Because of the severity of the disease, the vaccination schedule must not be modified as a result of pregnancy. If discovered pregnant during vaccination series, quickly consult the physician. Only the physician can adapt the vaccination program to the patient’s situation.

Breastfeeding

This vaccine may be used during breastfeeding.

Side effects

What side effects can occur from verorab?

Like all medicines, verorab may have side effects, including:

• Minor local reactions (such as injection-site pain, injection-site erythema, injection-site edema, injection-site pruritus, and injection-site induration)
• General reactions (moderate fever, shivering, malaise, asthenia, headache, dizziness, arthralgia, myalgia, gastrointestinal disorders, nausea, abdominal pain)
• Exceptional cases of anaphylactoid reaction, urticarial, and rash

In babies born very prematurely (at or before 28 weeks of gestation), longer gaps than normal between breaths may occur for 2-3 days after vaccinations.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with verorab?

Corticosteroids and other immunosuppressive treaments can interfere with the production of antibodies and lead to the failure of the vaccination.

Immunoglobulins must be administered at a different site from that of the vaccine (contralateral side).

Does food or alcohol interact with verorab?

Verorab may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with verorab?

Verorab may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using verorab.

What is the dose of verorab for an adult?

Pre-exposure prophylaxis

One injection of 1ml is given each day on days 0, 7 and 28.

The earliest day that the 3rd dose can be given to achieve effective immune status is day 21.

For those at regular and continuing risk, a single reinforcing dose of vaccine should be given at 1 year after the primary course has been completed. Further doses should be given at three to five-year intervals thereafter.

For travelers at intermittent risk of exposure, booster doses may be given in line with official recommendations.

Post-exposure prophylaxis

Post-exposure treatment should begin as soon as possible after the suspected contact. Immediate wound toilet is important to reduce the risk of infection, followed by the administration of the vaccine and passive immunization if indicated; this should be carried out in accordance with official recommendations.

• In persons known to have adequate prophylaxis, with the event of contact with a suspected rabid animal, two further boosters should be given, one on day 0 and one on day 3.
• In persons with no, or possibly inadequate, prophylaxis, the first injection of rabies vaccine (day 0) should be given as soon as possible after the suspected contact and followed by four further doses on days 3, 7, 14, and 30 (the earliest that the 5th dose can be given is day 28 as per WHO recommendations). The use of rabies immunoglobulin should be considered in unimmunized or incompletely immunized subjects or those with uncertain immune status in accordance with official recommendations and/or expert advice. The treatment schedule may be stopped if the animal concerned is found conclusively to be free of rabies.

Subjects with incomplete prophylaxis or unknown history of immunization should be treated as non-immune.

What is the dose of verorab for a child?

Pre-exposure prophylaxis

One injection of 1ml is given each day on days 0, 7 and 28.

The earliest day that the 3rd dose can be given to achieve effective immune status is day 21.

For those at regular and continuing risk, a single reinforcing dose of vaccine should be given at 1 year after the primary course has been completed. Further doses should be given at three to five-year intervals thereafter.

For travelers at intermittent risk of exposure, booster doses may be given in line with official recommendations.

Post-exposure prophylaxis

Post-exposure treatment should begin as soon as possible after the suspected contact. Immediate wound toilet is important to reduce the risk of infection, followed by the administration of the vaccine and passive immunization if indicated; this should be carried out in accordance with official recommendations.

• In persons known to have adequate prophylaxis, with the event of contact with a suspected rabid animal, two further boosters should be given, one on day 0 and one on day 3.
• In persons with no, or possibly inadequate, prophylaxis, the first injection of rabies vaccine (day 0) should be given as soon as possible after the suspected contact and followed by four further doses on days 3, 7, 14, and 30 (the earliest that the 5th dose can be given is day 28 as per WHO recommendations). The use of rabies immunoglobulin should be considered in unimmunized or incompletely immunized subjects or those with uncertain immune status in accordance with official recommendations and/or expert advice. The treatment schedule may be stopped if the animal concerned is found conclusively to be free of rabies.

Subjects with incomplete prophylaxis or unknown history of immunization should be treated as non-immune.

How is verorab available?

Verorab is available in the following dosage forms and strengths:

• Vaccine (inj) 1 dose + syringe (diluent) 0.5 ml

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

The physician will decide when to administer the missing dose.