Palforzia is the first treatment for peanut allergy approved by the U.S. Food and Drug Administration. It is an oral immunotherapy—meaning it works by giving carefully measured doses of peanut protein by mouth over time. The goal is to help the body become less reactive to accidental peanut exposure.
Palforzia is not a medication you swallow once a day at home and forget about. It is a structured medical treatment that our allergists supervise closely from start to finish. The program begins with a buildup phase in our office, followed by daily maintenance doses at home.
This treatment represents an important step forward for families living with peanut allergy. Until Palforzia became available, the main approach was strict avoidance and carrying epinephrine auto-injectors in case of accidental exposure. Now there is a way to reduce the risk of severe reactions if accidental exposure happens.
How Palforzia Works
Palforzia contains small, controlled amounts of peanut protein. By introducing tiny doses and gradually increasing them under medical supervision, the immune system can become less sensitive to peanut over time. This process is called desensitization.
The treatment does not teach the immune system to accept peanut as harmless. Instead, it raises the threshold for how much peanut protein it takes to trigger a reaction. That means accidental exposure to trace amounts—like cross-contamination in food—is less likely to cause a severe allergic reaction.
Palforzia is meant to be used alongside continued peanut avoidance. It is not a green light to eat peanut-containing foods freely. Think of it as a safety net that lowers the risk if something goes wrong despite your best efforts to avoid peanuts.
Who Can Receive Palforzia?
Palforzia is approved for children and teenagers between the ages of four and seventeen. Patients can continue the treatment after their eighteenth birthday, but they must start before turning eighteen.
To be eligible, your child must have a confirmed peanut allergy. That means they need a documented history of allergic reactions to peanut or positive allergy testing results that match their symptoms. At Allergy Affiliates, we use both skin testing and blood testing as part of a thorough allergy evaluation to make sure the diagnosis is accurate.
Before starting Palforzia, your child will also need to pass an initial oral food challenge in our office. During this challenge, our allergists give small, measured doses of peanut protein and watch closely for any reaction. This step confirms the diagnosis and establishes a baseline for treatment.
Palforzia is not right for everyone with peanut allergy. Children with uncontrolled asthma, a history of a condition called eosinophilic esophagitis, or certain other medical conditions may not be candidates. Our board-certified allergists will review your child's full medical history to determine whether Palforzia is a safe and appropriate option.
The Treatment Protocol
Palforzia treatment happens in two main phases: initial dose escalation, up-dosing, and maintenance.
Initial Dose Escalation
The first day of treatment takes place entirely in our office. Your child will receive several small doses of Palforzia over the course of a few hours while our team monitors them closely for any signs of a reaction. If all goes well, they will leave with a prescription to continue a small daily dose at home.
Up-Dosing Phase
About every two weeks, your child will return to our office for an up-dosing visit. At each appointment, we increase the amount of peanut protein in a controlled setting. You will stay in the office for at least one hour after each dose increase so we can watch for any reactions.
After each up-dosing visit, your child will take the new, higher dose at home every day until the next appointment. This phase lasts several months and requires commitment from the whole family. Missing doses or taking them inconsistently can set back progress or increase the risk of a reaction.
Maintenance Phase
Once your child reaches the highest dose level, they enter the maintenance phase. At this point, they take the same dose every day at home. Maintenance continues long-term—stopping Palforzia means the protection fades over time.
During maintenance, your child will still need regular follow-up visits with our allergists to make sure everything is going smoothly and to manage any concerns that come up.
What Palforzia Does Not Do
It is important to understand what Palforzia can and cannot do. This treatment is desensitization, not something that makes the allergy go away permanently.
Palforzia does not eliminate peanut allergy. Your child will still be allergic to peanuts. They will still need to avoid peanut-containing foods. They will still need to carry epinephrine auto-injectors at all times in case of accidental exposure.
What Palforzia does is reduce the chance that a small, accidental exposure will cause a severe reaction. It provides a margin of safety, but it does not give your child the freedom to eat peanuts whenever they want.
If your child stops taking Palforzia, the protection goes away. The immune system will gradually become sensitive to peanut again. That is why daily maintenance is so important—and why this treatment requires long-term commitment.
Palforzia also does not prevent all reactions. Some children still experience mild symptoms like stomach discomfort, itching, or throat irritation during treatment. Serious reactions are possible, though they are uncommon when the treatment is followed exactly as prescribed. That is why every dose increase happens in our office, and why we provide detailed instructions for taking doses safely at home.
Possible Side Effects
Like any medical treatment, Palforzia can cause side effects. Most are mild and happen in the mouth, throat, or stomach. These can include itching or tingling in the mouth, stomach pain, nausea, or vomiting.
Some children experience these symptoms regularly, especially during the up-dosing phase. Others have very few side effects. Our allergists will work with your family to manage symptoms and adjust the treatment plan if needed.
Serious allergic reactions are possible but not common. That is why each dose increase is supervised in our office. If your child ever has trouble breathing, develops hives all over their body, or shows other signs of a severe allergic reaction at home, use their epinephrine auto-injector right away and call 911.
Life During Palforzia Treatment
Starting Palforzia is a big decision that affects daily routines. Your child will need to take their dose at the same time every day, and they should avoid physical activity for a few hours afterward. Exercise, hot showers, and other activities that raise body temperature can increase the risk of a reaction right after taking a dose.
Families need to plan around the treatment schedule, especially during the up-dosing phase when office visits happen frequently. School, sports, and travel all require extra thought and preparation.
Despite these challenges, many families find that Palforzia brings peace of mind. The fear of accidental exposure can be significant when you are parenting a child with peanut allergy. Knowing that your child has some protection—even if it is not complete—can reduce anxiety and make everyday life feel a little safer.
Is Palforzia Right for Your Child?
Deciding whether to pursue Palforzia is a personal choice. Some families are eager to try this option. Others prefer to stick with strict avoidance and emergency preparedness.
At Allergy Affiliates, our allergists take the time to talk through the benefits and risks with every family. We will review your child's medical history, discuss what the treatment involves, and answer all your questions. We want you to feel confident and informed before making a decision.
If you are looking for a food allergy doctor in Sarasota, FL, or allergy testing near you in Bradenton, our team is here to help. We serve families from Bradenton, Sarasota, Lakewood Ranch, and throughout Manatee County.
When to See an Allergist
If your child has been diagnosed with peanut allergy—or if you suspect they might be allergic—seeing a board-certified allergist is the best first step. At Allergy Affiliates, we offer comprehensive allergy evaluation and treatment for both children and adults. Our services include allergy testing using skin testing and blood testing, asthma care, allergy immunotherapy through allergy shots, penicillin allergy testing, and Palforzia for peanut allergy.
If you would like to find out whether your child is a candidate for Palforzia, or if you need an allergist in Bradenton, FL, for any allergy-related concern, we encourage you to reach out. Call our office at 941-792-4151 or request an appointment online at allergyaffiliates.com/book.