Rabies Immunoglobulin (RIG) Dose for Dog Bite

Dose

Key Administration Rules

1. Timing: Given once only, on Day 0 (same day as first rabies vaccine dose). If not given on Day 0, it can still be administered up to Day 7 after the first vaccine dose. After Day 7, it is not indicated (antibody response is presumed underway).
2. Route & Site:
   • As much of the dose as anatomically feasible should be infiltrated directly into and around the wound.
   • Any remaining volume that cannot fit into the wound is injected intramuscularly at a site distant from the vaccine.
3. Never administer in the same syringe or same anatomic site as the rabies vaccine — they will neutralize each other.
4. Do not repeat: HRIG is given only once throughout the prophylaxis course.
5. Previously vaccinated patients: RIG is not given if the patient has prior complete pre- or post-exposure prophylaxis with documented antibody response.

Practical Notes

• Even if the wound needs suturing, infiltrate with HRIG first — this is safe and does not increase infection risk.
• Use caution in enclosed tissue compartments (e.g., finger pulp) — excess RIG can cause compartment pressure and necrosis.
• HRIG is contraindicated in patients with IgA deficiency and known anti-IgA antibodies (risk of severe allergic reaction).