Rabies Immunoglobulin (RIG): Who Needs It, and When
A bleeding bite from a dog, cat or monkey needs two things: the rabies vaccine course, and — until the vaccine takes effect — rabies immunoglobulin injected around the wound. This page explains what RIG is, who needs it, the time limit, the options in India, and how it is arranged when you come to Nirvana Clinic. Dr. Manuj Sondhi (MRCP UK, MD, DNB), Consultant Physician with a Fellowship in Infectious Diseases & HIV, leads the animal-bite service opposite Delta-1 Metro, Greater Noida.
The short version: RIG is a one-time injection of ready-made antibodies given into and around the wound. It is needed for every Category III exposure — any bite or scratch that draws blood, a lick on broken skin, saliva in the eyes, nose or mouth — in a person who has not completed a rabies vaccine course before. It is given on day 0, and no later than day 7 after the first vaccine dose. It is not needed for Category II exposures (unless your immunity is weakened) or if you have a record of a complete earlier course. It never replaces the vaccine; the two work together. Nirvana Clinic gives the first vaccine dose and refers you the same day to a nearby centre for RIG.
Not sure which category your bite is? Use the Animal Bite Navigator — five questions, one clear next step.
Why the Vaccine Alone Is Not Enough for Severe Bites
After a bite, the rabies virus stays in muscle and nerve endings near the wound for days to weeks before travelling along the nerves to the brain. The vaccine teaches your immune system to make its own antibodies — but that takes roughly 7 to 10 days. For a Category II graze that gap is acceptable. For a Category III wound — deeper, bleeding, closer to nerves — it is not, and that is the gap RIG fills.
What RIG does in that gap
It delivers antibodies directly at the wound within minutes, neutralising virus where it entered before it can reach a nerve. The effect lasts about two to three weeks, by which time the antibodies produced by the vaccine have taken over.
Why the site of the bite matters
The face, head, neck, hands and fingertips are richly supplied with nerves and close to the brain. Rabies from such bites can develop in a matter of weeks. These are exactly the wounds where RIG must not be skipped or delayed.
Why RIG is never given alone
RIG fades within weeks and does not train your immune system. Without the full vaccine course, protection would simply run out. See the five-dose vaccine schedule that runs alongside it.
Who Needs RIG — and Who Does Not
The decision depends on the category of exposure, your vaccination history and your immune status — not on how the animal looked or whether it was a pet.
| Situation | RIG? | What else |
|---|---|---|
| Category I — touched or fed the animal; lick on unbroken skin | No | No vaccine either. Wash the area. |
| Category II — nibbling of uncovered skin; minor scratch or graze without bleeding | No | Full 5-dose vaccine course. |
| Category III — any bite or scratch that breaks the skin; lick on broken skin; saliva in eyes, nose or mouth; any bat contact | Yes | Vaccine course plus RIG on day 0, and no later than day 7 after the first dose. |
| Category II in a person with weakened immunity — HIV, chemotherapy, long-term steroids, after a transplant | Yes | Managed as Category III: vaccine course plus RIG. |
| Previously completed full course with a cell-culture vaccine, with a card or record (after an earlier bite, or pre-exposure) | No | Two booster doses only, day 0 and day 3, whatever the category. |
| Category III presenting late — days or weeks after the bite, vaccine not yet started | Yes | RIG is given with the first dose regardless of how long ago the bite was. It is withheld only once more than 7 days have passed since the first vaccine dose. |
A scratch that bled from a cat or a monkey is Category III just as a dog bite is. The animal species changes nothing about whether RIG is needed.
The Three Options Available in India
All three do the same job: supply antibodies against the rabies virus at the wound. Which one you receive depends on what the centre giving it stocks; the names are listed so you can recognise what you are offered.
Equine RIG (ERIG)
Made from the serum of immunised horses; the most widely used option in India and what most hospitals and government anti-rabies centres stock. Dosed by body weight. Some centres still do a skin sensitivity test first. Allergic reactions are uncommon with modern purified products, but because they can occur, ERIG is given where a reaction can be managed immediately.
Human RIG (HRIG)
Made from the plasma of vaccinated human donors. No skin test, a smaller volume, no horse-serum allergy concern. Scarcer, so used mainly where ERIG cannot be given.
Rabies monoclonal antibodies
Laboratory-made antibodies — Rabishield (licensed in India in 2016) and TwinRab (2019) — approved as alternatives to RIG for Category III exposures and recognised by WHO as an option. Same purpose, same timing, same method of injection. Availability varies by centre.
How RIG Is Given
- The full weight-based dose is calculated first, then as much of it as possible is infiltrated into and around every wound — including small puncture marks and scratches, because the virus enters wherever the skin is broken.
- Any remaining volume is handled as the treating doctor advises under current national guidance.
- Never in the same syringe or at the same site as the vaccine. The vaccine goes into the deltoid muscle of the arm (the outer thigh in small children); RIG goes at the wound.
- It is given once. There is no second RIG dose, and repeating it later in the course is not useful.
- Awkward sites (a fingertip, an ear, the lip) limit how much can be infiltrated; the doctor adjusts the technique rather than skipping the wound. Stitching, if needed at all, comes after RIG, never before.
What Happens at Nirvana Clinic for a Category III Bite
Nirvana Clinic keeps the rabies vaccine in stock but does not stock RIG or monoclonal antibodies. Here is how the two are coordinated so nothing is delayed:
- Wound wash and category. A 15-minute wash with running water and soap if not already done, then an antiseptic. The doctor examines every wound, records the category, and reviews your tetanus protection.
- First vaccine dose from stock, today. Rabivax-S or Abhayrab is given at the same visit, so the clock on your course starts immediately. You leave with a written schedule for days 3, 7, 14 and 28.
- Same-day referral for RIG. You are referred the same day to a nearby hospital or anti-rabies centre that stocks RIG or a monoclonal antibody, with a written note stating the wound category, the vaccine given and the date. We tell you where to go and what to ask for.
- Doses 2 to 5 at the clinic. At the day-3 visit the doctor confirms RIG was received and records it on your card. If for any reason it was not, there is still time until day 7, and we help you get it.
Please don’t do these
Don’t skip RIG because the vaccine “has already been started” — they do different jobs, and a Category III bite needs both. Don’t accept RIG more than 7 days after your first vaccine dose — by then your own antibodies are forming, and late RIG can blunt that response rather than help. And don’t delay the first vaccine dose while you arrange RIG — vaccine first, at the clinic, then RIG the same day.
Bitten at night or on a Sunday? For a deep, bleeding or facial wound, go to the nearest hospital emergency department tonight — most can clean the wound and start rabies prevention, including RIG. See what to do in the first hours after a dog bite.
Special Groups
Pregnancy and breastfeeding
RIG and the vaccine are both given, at the usual dose and without delay. Neither is known to harm the baby; rabies itself is the danger.
Children
RIG is dosed by body weight, so a small child receives a smaller volume — never a smaller priority. Children are more often bitten on the face and head, which makes RIG more important, not less.
Previously vaccinated
A documented complete course is the one situation in which RIG is correctly withheld: two booster doses on day 0 and day 3 are enough. Keep your vaccination card.
Bitten days or weeks ago and never treated? RIG and the vaccine are still given in full — read why it is not too late, and why today still matters.
Care Led by Dr. Manuj Sondhi
MRCP (UK), MD, DNB · Consultant Physician & Diabetologist
2-year Fellowship in Infectious Diseases & HIV, Tata Memorial Hospital · Visiting Consultant, Infectious Diseases, Fortis Greater Noida
Dr. Sondhi assesses animal bites, starts the vaccine course at the same visit, arranges RIG where it is needed, and follows the course through to completion. He also runs the clinic’s infectious disease service. Read his full profile.
📍 GF-93, Ground Floor, Sun Twilight Complex, opposite Delta-1 Metro Station, Greater Noida 201308 · Mon–Sat 9 AM–8 PM · 5.0 ★ · 350+ Google reviews
Frequently Asked Questions
Is RIG necessary if I have already taken the first rabies vaccine dose?
For a Category III exposure, yes. The vaccine takes about 7 to 10 days to produce protective antibodies, and rabies immunoglobulin covers that gap by neutralising virus at the wound. It can be given up to day 7 after the first vaccine dose, so if you were not given it on day 0, ask for it at your next visit rather than waiting.
Can rabies immunoglobulin be given after a week?
No. RIG is useful only until day 7 after the first vaccine dose. After that your own antibody response has started and RIG is no longer recommended. If more than 7 days have passed since your first dose, complete the vaccine course on schedule; if the vaccine has not been started at all, both RIG and vaccine are given regardless of how long ago the bite was.
Is equine rabies immunoglobulin safe?
Modern purified equine RIG is used widely in India and serious allergic reactions are uncommon. Because reactions can occur, it is given at hospitals and designated anti-rabies centres where they can be treated immediately. Some centres do a skin sensitivity test first. If equine RIG cannot be used, human RIG or a rabies monoclonal antibody is the alternative.
Is a rabies monoclonal antibody the same as RIG?
It does the same job. Rabies monoclonal antibodies such as Rabishield and TwinRab are laboratory-made antibodies licensed in India as alternatives to RIG for Category III exposures, and WHO recognises them as an option for passive immunisation. They are given at the same time and in the same way as RIG, into and around the wound, and do not replace the vaccine course.
Why doesn't Nirvana Clinic keep RIG?
RIG and rabies monoclonal antibodies are held by hospitals and designated anti-rabies centres that have the cold chain and emergency support to give them. Nirvana Clinic's role is to assess the wound, give the first vaccine dose immediately from stock, and refer you the same day with a written note to a nearby centre for RIG. You then complete the remaining vaccine doses at the clinic.
Do pregnant women receive rabies immunoglobulin?
Yes. Both rabies immunoglobulin and the rabies vaccine are given in pregnancy and during breastfeeding, without delay and at the usual dose. Rabies is almost always fatal once symptoms appear, and neither RIG nor the vaccine is known to harm the baby.
I completed the full rabies vaccine course last year. Do I need RIG after a new bite?
No. If you have a record of a complete cell-culture rabies vaccine course, a new exposure of any category is managed with two booster doses on day 0 and day 3, and RIG is not given. Without a record, or if the earlier course was incomplete, the exposure is treated as new and RIG is needed for a Category III bite.
Bleeding Bite? Vaccine First, RIG the Same Day
Walk in near Delta-1 Metro: first vaccine dose from stock, and a written RIG referral in your hand before you leave. Message first if you are coming from Noida Extension, Gaur City or Pari Chowk.