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[Pharmacology](https://durgical.com/en/pharmacology/) · [Immunoglobulins and antitoxins](https://durgical.com/en/pharmacology/classes/immunoglobulins-and-antitoxins/)

# Rabies immunoglobulin

Antibodies against rabies virus that are infiltrated into the wound after severe exposures, while the vaccine builds the body's own response.

Updated 2026-11-01

- Class: [Immunoglobulins and antitoxins](https://durgical.com/en/pharmacology/classes/immunoglobulins-and-antitoxins/)
- Target: Rabies virus glycoprotein G
- ATC code: J06BB05
- WHO Model List of Essential Medicines

Also called: Human rabies immunoglobulin (HRIG), Equine rabies immunoglobulin, Anti-rabies monoclonal antibodies

◆**Rabies virus glycoprotein G**Rabies immunoglobulin

ⓘ The figure shows the rabies virus glycoprotein bound to the fragment of a human neutralising antibody (RVA122); the antibodies in the immunoglobulin act on this protein.

**Target in 3D:** Rabies virus glycoprotein G. PDB structure 7U9G (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7U9G) · Drag to rotate · pinch to zoom

## Mechanism of action

Rabies is almost always fatal once symptoms start. The vaccine takes days to induce antibodies; during that gap, immunoglobulin infiltrated into the wound neutralises virus at the entry site before it reaches peripheral nerves. It can be human, equine or a monoclonal antibody.

- The wound is washed thoroughly
- Antibodies are infiltrated into and around the wound
- They neutralise virus before it enters nerves
- The vaccine, given at the same time, provides lasting protection

## Pharmacokinetics

**Distribution**
Acts mainly in the wound tissue where it is infiltrated

**Onset and duration**
Immediate: it covers the gap until the vaccine induces antibodies

## Indications

- WHO category III post-exposure prophylaxis (transdermal bites or scratches, saliva on mucosa or broken skin, direct contact with bats), together with the vaccine

## Adverse effects

### Common

- Pain and discomfort at the infiltration site

### Serious (rare, important)

- Anaphylaxis or serum sickness (more with equine products)

## Contraindications

- Not given to people with documented previous rabies vaccination
- Not given more than seven days after the first vaccine dose

## Key interactions

**Rabies vaccine**
Used together; the immunoglobulin does not replace the vaccine, which must be completed

## What is monitored

- Exposure category (I, II or III)
- Previous rabies vaccination
- Allergic reactions during and after administration

## Administration and safety

- Infiltrate into and around the wound
- Do not give with the same syringe or at the same site as the vaccine
- Equine products: keep anaphylaxis treatment at hand; prior skin testing is unreliable and WHO advises against it

## Nursing care

- Wash the wound thoroughly with soap and water straight away
- Record the exposure category and the date of the first vaccine dose
- Watch for allergic reaction, especially with equine products
- Explain why the vaccine course must be completed

## Pregnancy and breastfeeding

Rabies is almost always fatal once symptoms start; in pregnancy post-exposure prophylaxis is considered as for anyone exposed.

## Memory aid

Rabies category III = "wash, infiltrate, vaccinate": the immunoglobulin goes into the wound, the vaccine elsewhere.

## Test yourself

Think of the answer, then tap the question to see it.

## In which WHO exposure category is rabies immunoglobulin added to the vaccine?

Category III: transdermal bites or scratches, saliva contamination of mucosa or broken skin, and direct contact with bats.

## Where is rabies immunoglobulin given?

Infiltrated into and around the wound; WHO no longer recommends injecting the remainder at a distant site.

## Who does not need immunoglobulin after a rabies exposure?

A person with documented previous rabies vaccination; it is also no longer indicated more than seven days after the first vaccine dose.

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## Related drugs

- [Human tetanus immunoglobulin](https://durgical.com/en/pharmacology/human-tetanus-immunoglobulin/)

[← Back to the class: Immunoglobulins and antitoxins](https://durgical.com/en/pharmacology/classes/immunoglobulins-and-antitoxins/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Rabies](https://www.who.int/news-room/fact-sheets/detail/rabies) (World Health Organization, 2026); [The WHO position on rabies immunization – 2018 updates](https://pmc.ncbi.nlm.nih.gov/articles/PMC6863036/) (Vaccine (PubMed Central), 2019); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J06BB05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/rabies-immunoglobulin/