Verorab Dosage/Direction for Use

Always use this medicine exactly as told by the doctor or pharmacist. Check with the doctor or pharmacist if not sure.
Intramuscular use (IM): the recommended dose is 0.5 mL of reconstituted vaccine.
Intradermal use (ID): the recommended dose is 0.1 mL of reconstituted vaccine per injection site.
Pre-exposure prophylaxis: For pre-exposure immunisation, immunocompetent individuals can be vaccinated according to one of the vaccination schedules presented in Table 1 and according to official recommendations. (See Table 1.)

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Booster doses are determined based on the risk of exposure and on serological tests in accordance with official recommendations.
Post-exposure prophylaxis: Post-exposure prophylaxis includes local non-specific treatment of the wound, vaccination and, where appropriate, passive immunisation with rabies immunoglobulins. Post-exposure prophylaxis should be initiated as soon as possible after suspected exposure to rabies. In all cases, proper wound care (careful washing of all bites and scratches with soap or detergent and copious amounts of water and/or virucidal agents) must be performed immediately or as soon as possible after exposure. It must be performed before administration of rabies vaccine or rabies immunoglobulin, where they are indicated. Post-exposure prophylaxis should be adjusted to the exposure category, the condition of the animal (see Table 3) and the vaccination status of the patient, in accordance with official recommendations (see Table 3, WHO recommendations).
If necessary, post-exposure prophylaxis can be supplemented by tetanus prophylaxis and antibiotic therapy to prevent the development of infections other than rabies.
Post-exposure prophylaxis should be performed as soon as possible after exposure under medical supervision and only at a rabies centre. (See Tables 2 and 3.)

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Click on icon to see table/diagram/image

Post-exposure prophylaxis in non-immunised subjects: Non-immunised subjects may be vaccinated according to one of the vaccination regimens by intramuscular use (IM) or by intradermal use (ID) presented in Table 4. (See Table 4.)
In all cases, refer to the local official recommendations.

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Whatever the regimen used, vaccination must not be discontinued unless the contact animal is declared free from rabies after veterinary supervision (see Table 3).
Rabies immunoglobulins should be administered in the event of any category III exposure (WHO classification, see Table 2). If possible, the vaccine should be administered contralaterally to the immunoglobulin administration sites.
Refer to the package leaflet of the rabies immunoglobulins used.
Post-exposure prophylaxis in already immunised subjects: In accordance with official recommendations, this applies to subjects who have already received pre-exposure prophylaxis or post-exposure prophylaxis or who discontinued post-exposure prophylaxis after receiving at least two doses of vaccine prepared in cell culture.
Subjects who have already been immunised must receive 1 dose of vaccine (0.5 mL intramuscularly or 0.1 mL intradermally) on D0 and 1 dose on D3.
Alternatively, 4 intradermal injections of 0.1 mL may be administered in 4 separate sites on D0.
Rabies immunoglobulins are not indicated in this case.
Individuals with decreased immunity: Pre-exposure prophylaxis: In individuals with decreased immunity, conventional three-dose regimens should be used (see Table 1) and a serological test for neutralising antibodies should be performed 2 to 4 weeks after the last dose of the vaccine to assess the need for a possible additional dose of vaccine.
Post-exposure prophylaxis: In individuals with decreased immunity, a complete vaccination regimen should be administered (see Table 4). Rabies immunoglobulins should be administered in association with the vaccine in the event of any category II and III exposure (see Table 1).
Use in children: A child must receive the same dose as an adult (0.5 mL intramuscularly or 0.1 mL intradermally).
Method of administration: Intramuscular use (IM): The vaccine is administered in the anterolateral region of the thigh muscle in infant and young children and in the deltoid muscle in older children and adults.
If the Zagreb regimen is used, one dose should be administered in each deltoid muscle (left and right) in adults at D0, then one dose at D7 and D21.
Intradermal use (ID): The vaccine should ideally be administered in the upper arm or the forearm.
The vaccine must not be injected in the buttocks region.
The vaccine must not be injected via the intravascular route.
If there are any further questions on the use of this medicine, ask the doctor or pharmacist or nurse.