Ready-made antibodies given with the rabies vaccine after a high-risk bite
Rabies immunoglobulin
Ready-made antibodies given as soon as possible after a high-risk rabies exposure to give immediate protection while the vaccine takes effect.
What is Rabies immunoglobulin?
Rabies immunoglobulin is a preparation of ready-made antibodies given as emergency treatment after a bite, scratch or other exposure that could carry rabies. It gives immediate, short-term protection while the rabies vaccine, given at the same time, builds the body's own longer-lasting defence. It is a true emergency: it should be given as soon as possible, ideally as part of the first wound treatment, with as much as possible put into and around the wound itself. It is a blood product, used under specialist guidance, and you should never delay seeking care after a possible rabies exposure.
Education and reference only. This is a plain-language guide to Rabies immunoglobulin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Rabies immunoglobulin is a blood product made up of ready-made antibodies against the rabies virus. It is used after a high-risk exposure, such as a bite or scratch from an animal that may have rabies, to provide protection straight away. Because the body takes a couple of weeks to make its own antibodies after the rabies vaccine, the immunoglobulin fills that dangerous gap by supplying protection immediately. It is given together with the rabies vaccine, not instead of it, and is reserved for people who have not been vaccinated against rabies before or who are not fully protected. It is given under specialist and public-health guidance.
How it works
Rabies immunoglobulin supplies antibodies that can attach to and neutralise the rabies virus right away, before it has a chance to travel along the nerves and reach the brain. This is called passive protection, because the antibodies are given ready-made rather than being produced by the body. As much as possible is put into and around the wound, where the virus first enters, to neutralise it at the source; any remaining amount is given by injection into a muscle. Meanwhile the rabies vaccine, given separately, prompts the body to make its own antibodies, which take over as the immunoglobulin fades. Together they cover the whole at-risk period.
Company & origin
Originated / developed by: Specialist manufacturers.
A blood product used in the UK as emergency treatment, alongside the rabies vaccine, after a bite or exposure that carries a risk of rabies.
Practical use
How to take Rabies immunoglobulin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Treat any possible rabies exposure as an emergency and seek urgent medical care straight away.
- Wash the wound thoroughly with soap and running water as soon as possible, before and while seeking treatment.
- Have it given as soon as possible, ideally as part of the first wound treatment, with as much as possible placed into and around the wound.
- Have the rabies vaccine at the same time as directed, as the immunoglobulin and vaccine work together.
- Tell the team if you have had rabies vaccination before, as you may need the vaccine alone rather than the immunoglobulin.
Weighing it up
Advantages & disadvantages of Rabies immunoglobulin
Advantages
- Gives immediate protection in the dangerous gap before the vaccine takes effect.
- Neutralises the virus at the wound, where it first enters the body.
- A life-saving emergency treatment when given promptly after a high-risk exposure.
Disadvantages
- Is a blood product, so it is given under careful supervision.
- Must be given as soon as possible; any delay reduces how well it protects.
- Works only alongside the rabies vaccine, not as a stand-alone treatment.
Practical use
Good to know
The single most important thing to understand is that a possible rabies exposure is a medical emergency and rabies immunoglobulin should be given as soon as possible, because rabies is almost always fatal once symptoms appear but is preventable if treated promptly. It is used alongside the rabies vaccine, not on its own, and as much as possible is infiltrated directly into and around the wound, which is also washed thoroughly with soap and water. It is reserved for people who are not already protected against rabies; those who have been fully vaccinated before usually need the vaccine alone. Because it is a blood product, it is given under careful supervision, and the wound, injection sites and any reaction are monitored. Never delay washing the wound or seeking urgent medical care while arranging treatment.
Who should not take it / use with caution
- There are no absolute reasons to withhold it after a genuine high-risk rabies exposure, because rabies is otherwise almost always fatal.
- People who have already been fully vaccinated against rabies usually need the vaccine alone, not the immunoglobulin.
- It is used with care in people who have had a serious reaction to a blood product before, under specialist guidance.
Monitoring
- Checking the wound is properly cleaned and that as much as possible is infiltrated around it.
- Watching for any reaction at the injection sites or signs of an allergic reaction.
- Making sure the full course of rabies vaccine is completed alongside it.
Side effects
- Soreness, redness or swelling where the injection is given.
- A mild temperature or feeling generally unwell for a short time.
- Rarely, an allergic-type reaction, which is why it is given under supervision.
Key interactions
- It can briefly reduce how well some live vaccines work, so the timing of those is reviewed by your team.
- It does not interfere with the rabies vaccine, which is given at the same time but in a different place.
- Tell the team about all your medicines and any recent vaccinations.
Available as: A solution for injection, infiltrated into and around the wound and into a muscle.
Answers
Rabies immunoglobulin: frequently asked questions
What is rabies immunoglobulin used for?
It is given as emergency treatment after a bite or exposure that could carry rabies, to provide immediate protection while the rabies vaccine builds the body's own defence.
Why must it be given so quickly?
Rabies is almost always fatal once symptoms appear but is preventable if treated promptly, so the immunoglobulin and vaccine should be given as soon as possible after exposure.
Does it replace the rabies vaccine?
No. It works alongside the vaccine, giving immediate ready-made antibodies while the vaccine prompts your body to make its own longer-lasting protection.
Why is it put into the wound?
As much as possible is placed into and around the wound to neutralise the virus where it first enters the body, before it can spread along the nerves.
Do I need it if I have been vaccinated before?
People who have been fully vaccinated against rabies usually need the vaccine alone rather than the immunoglobulin; your team will decide based on your history.
The wider class
About Immunoglobulin (passive immunisation against rabies)
Rabies immunoglobulin belongs to the immunoglobulin (passive immunisation against rabies) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.