What Is Palforzia? Uses, Dosage, and What You Need to Know in 2026

Palforzia was one of the most significant milestones in the history of food allergy treatment. As the first and only FDA-approved oral immunotherapy for peanut allergy, it represented a fundamental shift from the decades-long approach of simply telling patients to avoid peanuts and carry an EpiPen. Here is a complete guide to what Palforzia is, how it works, who it is for, and what the 2026 discontinuation means for current and prospective patients.

What Is Palforzia?

Palforzia is the brand name for peanut (Arachis hypogaea) allergen powder-dnfp — a biologic product made from defatted, roasted peanut flour, packaged in precisely measured capsules and sachets. It was developed by Aimmune Therapeutics, received FDA approval on January 31, 2020, and was originally indicated for children ages 4 through 17 with a confirmed peanut allergy diagnosis. In 2024, the FDA expanded the indication to include toddlers ages 1 through 3. The drug was later acquired by Nestlé Health Science and then by Stallergenes Greer, which announced its voluntary discontinuation in January 2026.

What Is Palforzia Used For?

Palforzia is indicated to help reduce the severity of allergic reactions — including anaphylaxis — that may occur with accidental exposure to peanut. It is used in conjunction with a peanut-avoidant diet and is not a cure for peanut allergy. Palforzia is also not indicated for the emergency treatment of allergic reactions — patients must always carry injectable epinephrine even while on Palforzia therapy.

The goal of Palforzia is desensitization: gradually building the immune system's tolerance to peanut protein so that small, accidental exposures — a shared kitchen utensil, a trace amount in a food product — are less likely to trigger a severe or life-threatening reaction. In the pivotal PALISADE clinical trial, approximately 67% of Palforzia-treated patients (ages 4-17) could tolerate at least 600 mg of peanut protein without dose-limiting symptoms after completing the full treatment protocol.

Who Is Palforzia For?

Palforzia is FDA-approved for:

Children ages 1 through 17 with a confirmed diagnosis of peanut allergy (IgE-mediated)

Patients who have tested positive for peanut allergy via skin prick test or blood IgE test

Patients who have access to injectable epinephrine at all times

Patients whose provider is enrolled in the Palforzia REMS program

Palforzia is

NOT appropriate for patients with: uncontrolled asthma, a history of eosinophilic esophagitis (EoE) or other eosinophilic GI disease, or who are unwilling or unable to use epinephrine.

Palforzia Dosage: The Three Phases of Treatment

Palforzia treatment is divided into three distinct phases:

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Phase 1: Initial Dose Escalation (Single Clinic Day)

On a single day in a certified healthcare setting, patients receive escalating doses of Palforzia every 20-30 minutes under continuous observation. For patients ages 4-17, doses escalate from 0.5 mg through 1 mg, 1.5 mg, 3 mg, and 6 mg (Levels A-E). For toddlers ages 1-3, escalation goes from 0.5 mg to 3 mg (Levels A-D). The patient is observed for at least 60 minutes after the final dose before being discharged.

Phase 2: Up-Dosing (Approximately 6 Months)

Up-Dosing consists of 12 increasing dose levels, typically progressing from 3 mg daily up to 300 mg daily over approximately six months. The first dose of each new level is always administered in the clinic with a minimum 60-minute observation period. Between clinic visits, the patient takes their current dose daily at home. The 3 mg dose level (where this drug variant name comes from) is the starting point of the Up-Dosing phase for patients who completed Initial Dose Escalation.

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Phase 3: Maintenance (Ongoing)

Once a patient reaches and tolerates the 300 mg dose (equivalent to approximately one whole peanut), they transition to the Maintenance phase. In Maintenance, patients take 300 mg of peanut protein daily — from a sachet emptied into food — to maintain their achieved level of tolerance. Maintenance is a long-term commitment; stopping daily doses can reverse desensitization over time.

How Do You Take Palforzia?

The powder inside each Palforzia capsule or sachet is emptied and mixed with a small amount of semi-solid food — such as applesauce, yogurt, or pudding — and swallowed. The capsule itself is not swallowed. The powder must never be inhaled. It should be taken with food and followed by at least 30-60 minutes of rest (no exercise). Cold, refrigerated storage (2-8°C) is required.

The 2026 Discontinuation: What It Means

As of July 31, 2026, Stallergenes Greer is voluntarily ceasing all commercialization of Palforzia — not for safety or efficacy reasons, but because of commercially challenging market conditions driven by complex REMS requirements. This means no new patients can start Palforzia, and current patients need to plan a transition to an alternative therapy. Read our full Palforzia shortage update for the complete timeline and patient action steps.

Where Can You Still Find Palforzia?

Remaining Palforzia supply is available at REMS-certified specialty pharmacies for patients already in therapy. medfinder can help you locate which specialty pharmacies near you still carry your specific Palforzia dose. Contact the Palforzia Pathway Hub (1-844-PALFORZ) as well for transition support.