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Dose of monoclonal antibody for rabies

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Quick answer

Rabies monoclonal antibodies are used for post-exposure prophylaxis, infiltrated into and around all wounds as soon as possible, together with rabies vaccine.
Dose depends on the product:
  • Rabishield (twinrab, India): 3.33 IU/kg body weight
  • Rabivax-S / other RmAbs: follow the specific manufacturer label, commonly expressed in IU/kg or mL/kg
  • WHO principle: use the entire calculated dose for wound infiltration. Do not inject the remainder routinely into a distant muscle. If necessary, dilute with sterile normal saline to infiltrate all wounds.
It should ideally be given on day 0 with the first vaccine dose, but can be given up to day 7 after starting vaccine. It is not indicated for people previously fully vaccinated against rabies.
Because brands and vial strengths differ, confirm the exact product and its package insert before calculating the mL dose.
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