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Twinrab is a novel combination of two murine-derived monoclonal antibodies, docaravimab and miromavimab, developed by Zydus Lifesciences for rabies post-exposure prophylaxis. It is designed to provide immediate passive immunity by neutralizing the rabies virus at the site of infection, serving as a replacement for human or equine-derived rabies immunoglobulin (RIG). The two antibodies bind to distinct, non-overlapping epitopes on the rabies virus glycoprotein (G protein), ensuring broad-spectrum coverage against various rabies virus strains and reducing the risk of viral escape mutants. Twinrab is typically administered via infiltration into and around the wound, with any remaining volume injected intramuscularly at a site distant from the rabies vaccine injection.
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