Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.sirolimusSerious - Use Alternative (1)sirolimus decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.tacrolimusSerious - Use Alternative (1)tacrolimus decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.temsirolimusSerious - Use Alternative (1)temsirolimus decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.teplizumabSerious - Use Alternative (1)teplizumab decreases effects of rabies vaccine by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer all age-appropriate vaccinations before starting teplizumab. Inactivated or mRNA vaccines are not recommended within 2 weeks before teplizumab treatment, during treatment, or 6 weeks after completion of treatment.tocilizumabSerious - Use Alternative (1)tocilizumab decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.tralokinumabMonitor Closely (1)tralokinumab will decrease the level or effect of rabies vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Limited data are available regarding coadministration with non-live vaccines.triamcinolone acetonide injectable suspensionSerious - Use Alternative (1)triamcinolone acetonide injectable suspension decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.ublituximabMonitor Closely (1)ublituximab decreases effects of rabies vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.ustekinumabMonitor Closely (1)ustekinumab decreases effects of rabies vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Inactivated vaccinations administered during ustekinumab treatment may not elicit an immune response sufficient to prevent disease.voclosporinMonitor Closely (1)voclosporin decreases effects of rabies vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment. Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), submit an online report at https://vaers.hhs.gov/reportevent.html or call 1-800-822-7967 >10% Injection site reactions (eg, pain, erythema, swelling or itching) (25%) Headache (20%) Nausea (20%) Abdominal pain (20%) Muscle aches (20%) Dizziness (20%) 1-10% Serum sickness (7%) Postmarketing Reports Blood and lymphatic system disorders: Lymphadenopathy Immune system disorders: Anaphylactic reaction, serum sickness type reaction, dermatitis allergic, pruritus (itching), edema Nervous system disorders: Paresthesia, neuropathy, convulsion, encephalitis, Guillain-Barré-like syndrome Gastrointestinal disorders: Vomiting, diarrhea Musculoskeletal and connective tissue disorders: Arthralgia General disorders and administration site conditions: Asthenia, malaise, fever and chills (shivering), injection site hematoma Respiratory, thoracic, and mediastinal disorders: Wheezing, dyspnea Contraindications Preexposure prophylaxis Known life-threatening hypersensitivity to vaccine, neomycin, or any component of a vaccine Postexposure prophylaxis None Cautions Do not inject vaccine into gluteal area as administration in this area may result in lower neutralizing antibody titers The product is provided in a single dose vial; because the single dose vial contains no preservative, it is not to be used as a multidose vial for intradermal injection In both pre-exposure and postexposure immunization, the full 1.0 mL dose should be given intramuscularly When dose must be administered to person with history of hypersensitivity, antihistamines may be given; have epinephrine (1:1000) and other appropriate agents readily available to counteract anaphylactic reactions while carefully monitoring after immunization Serum sickness type reactions reported in persons receiving booster doses for preexposure prophylaxis; characterized by onset ~2-21 days post-booster, presents with generalized urticaria, and may also include arthralgia, arthritis, angioedema, nausea, vomiting, fever, and malaise Rare cases of neurologic illness resembling Guillain-Barré syndrome, a transient neuroparalytic illness, that resolved without sequelae in 12 weeks, and a focal subacute central nervous system disorder temporally associated with HDCV, reported Product contains albumin, a derivative of human blood; based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD); there is theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote; no cases of transmission of viral diseases, CJD, or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products Vaccination may not protect 100% of vaccinated individuals In adults and children, the vaccine should be injected into deltoid muscle; in infants and small children, the anterolateral aspect of the thigh is preferable While concentration of antibiotics in each dose of vaccine is extremely small, persons with known hypersensitivity to any of these agents, or any other component of the vaccine, could manifest an allergic reaction; while the risk is small, it should be weighed in light of potential risk of contracting rabies All serious systemic neuroparalytic or anaphylactic reactions to a rabies vaccine should be immediately reported to VAERS at 1-800-822-7967 (http://vaers.hhs.gov) or Sanofi Pasteur Inc., 1-800-VACCINE (1-800-822-2463) Drug interaction overview Immunosuppressive drugs Corticosteroids or other immunosuppressive can interfere with the development of active immunity and predispose the patient to developing rabies Do not administer immunosuppressive agents during postexposure therapy, unless essential for the treatment of other conditions When rabies postexposure prophylaxis is administered to persons receiving steroids or other immunosuppressive therapy, test for rabies antibody to ensure that an adequate response has developed Pregnancy Preexposure Animal reproduction studies have not been conducted It is also not known whether rabies vaccine can cause fetal harm when administered to pregnant women or can affect reproductive capacity Administer to pregnant women only if potential benefits outweigh potential risks If there is substantial risk of exposure to rabies, preexposure prophylaxis may also be indicated during pregnancy Postexposure Because of the potential consequences of inadequately treated rabies exposure and limited data that indicate that fetal abnormalities have not been associated with rabies vaccination, pregnancy is not considered a contraindication to postexposure prophylaxis Lactation Unknown if excreted in human milk; exercise cautionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Inactivated virus vaccine provides immunity to rabies by eliciting an active immune response Pharmacokinetics Onset (antibodies): 7-10 days Duration (antibodies): >1 year Peak Plasma Time (antibodies): 30-60 days IM Preparation Using the longer of the 2 needles supplied, transfer the entire contents of provided diluent into vaccine vial to reconstitute the freeze-dried vaccine Mix gently to avoid foaming The creamy white to orange freeze-dried vaccine dissolves to a pink-to-red suspension Withdraw total amount of dissolved vaccine into the syringe and replace long needle with smaller needle for IM injection IM Administration Adults and older children: Inject IM in deltoid muscle Infants and small children: Inject IM in anterolateral aspect of the thigh Do not inject in gluteal area; may result in lower neutralizing antibody titers Storage Refrigerate at 2-8ºC (35-46ºF) Do not freeze BRAND FORM. UNIT PRICE PILL IMAGE Imovax Rabies Vaccine (PF) intramuscular- 2.5 unit vialCopyright © 2010 First DataBank, Inc.Print Patient Educationrabies vaccine,human diploid (PF) intramuscular NO MONOGRAPH AVAILABLE AT THIS TIME USES: Consult your pharmacist. HOW TO USE: Consult your pharmacist. SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Consult your pharmacist. DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. NOTES: No monograph available at this time. MISSED DOSE: Consult your pharmacist. STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Information last revised July 2016. Copyright(c) 2023 First Databank, Inc. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. 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