Take Control of Peanut Allergies: What You Need to Know About Palforzia

Understanding Peanut Allergy and the Role of Palforzia

Peanut allergy affects 1-2% of people in the United States, making it one of the most common food allergies (1). This happens when the immune system mistakes proteins in peanuts for harmful substances. When this occurs, the body releases chemicals that trigger allergic reactions, which can range from mild symptoms to life-threatening anaphylaxis (2).

Peanuts are legumes, not tree nuts, and are related to soybeans, peas, and lentils (3). Peanut allergy is the most common cause of food-related anaphylaxis (2). A 2017 study showed that peanut allergies in U.S. children have increased by 21% since 2010 (3). Children who have eczema, an egg allergy, or both are at higher risk (2).

Even though peanut is one of the eight major allergens that must be listed on food labels under the Food Allergen Labeling and Consumer Protection Act of 2004, accidental exposure still happens (3). Because of the potential severity of peanut allergy and the risk of accidental exposure, affected individuals and parents often seek ways to reduce the risk of anaphylaxis.

In 2020, a new treatment called Palforzia became available. Palforzia is a peanut allergen powder designed to reduce allergic and anaphylactic reactions to accidental exposure to small amounts of peanuts (4).

How Palforzia Works

Palforzia is approved for patients with a confirmed peanut allergy diagnosis (5). It is a type of oral immunotherapy, which means patients are given very small, gradually increasing amounts of peanut protein to help their immune system become less reactive over time (5).

The treatment can be started in children ages 4-17 and continued in adults 18 and older (4). Therapy involves three phases over 6-12 months, and patients still need to follow a peanut-free diet. Each dose is administered in a doctor’s office, where the patient is observed for one hour for a reaction. If the dose is tolerated, it continues at home for two weeks, after which the patient returns for a higher supervised dose. This process continues until the patient can handle 300 mg of peanut protein—about the amount in a single peanut (4).

Risks and Precautions

While Palforzia can help lower the risk of anaphylaxis, it is not without risks. Anaphylaxis can occur during any phase of dosing (6). Common side effects include stomach pain, throat irritation, and itching in the mouth (4).

The treatment is not safe for patients with uncontrolled asthma or eosinophilic gastrointestinal disease (4). It is also not recommended for patients taking medications that may interfere with epinephrine such as some drugs used for high blood pressure (6,7). Allergic reactions while on Palforzia may be more likely during exercise, hot showers, viral illnesses, fasting, menstruation, lack of sleep, or after taking NSAIDs (6).

Even after successful therapy, patients must continue carrying injectable epinephrine and avoid eating more than a single peanut at a time (4).

Why Palforzia Matters

Currently, Palforzia is the only FDA-approved oral immunotherapy for peanut allergy (3). Accidental peanut exposure can trigger anaphylaxis within seconds or up to two hours after eating peanuts (8). Palforzia provides a structured approach to reduce the severity of allergic reactions and gives families a sense of control over an unpredictable condition.

Final Thoughts

Palforzia is a promising option for patients with peanut allergy, offering protection against accidental exposure while still requiring careful supervision. It is not a cure, but it can significantly improve safety and confidence in daily life. Patients and caregivers should weigh the benefits of immunotherapy against its risks, follow medical guidance closely, and remain prepared for emergencies. As research continues, therapies like Palforzia may lead to even safer, more effective ways to manage food allergies and improve the quality of life for those affected.

References 

1.     American Academy of Allergy, Asthma & Immunology. Everything You Need to Know About Peanut Allergy. Tools for the Public – Conditions Library. American Academy of Allergy, Asthma & Immunology; updated May 21, 2025. Accessed September 1, 2025. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/peanut-allergy

2.     Mayo Clinic Staff. Peanut allergy – Symptoms and causes. Mayo Clinic. March 25, 2025. Accessed September 1, 2025. https://www.mayoclinic.org/diseases-conditions/peanut-allergy/symptoms-causes/syc-20376175

3.     American College of Allergy, Asthma & Immunology. Peanut Allergy: Causes, Symptoms & Treatment. ACAAI. Accessed September 1, 2025. https://acaai.org/allergies/allergic-conditions/food/peanut/

4.     Erlich D. Peanut Allergen Powder (Palforzia) for Peanut Allergy. Am Fam Physician. 2022;105(1):20–21. Accessed September 1, 2025. https://www.aafp.org/pubs/afp/issues/2022/0100/p20.html

5.     U.S. Food and Drug Administration. Palforzia (Peanut [Arachis hypogaea] Allergen Powder-dnfp). FDA. Content current as of August 1, 2024. Accessed September 1, 2025. https://www.fda.gov/vaccines-blood-biologics/allergenics/palforzia

6.     Stallergenes Greer. PALFORZIA HCP Site. palforziapro.com. Accessed September 1, 2025. https://www.palforziapro.com/

7.     Dalal R, Grujic D. Epinephrine. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. Updated November 23, 2024. Bookshelf ID: NBK482160. https://www.ncbi.nlm.nih.gov/books/NBK482160/

8.     Patel R. Peanut Allergy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. Updated July 4, 2023. Accessed September 1, 2025. https://www.ncbi.nlm.nih.gov/books/NBK538526/

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