Palforzia
Palforzia (peanut allergen powder) is a medication used to treat children who are allergic to peanuts. It won't cure a peanut allergy, but can help make allergic reactions to peanuts less severe. Because this medication can cause a life-threatening allergic reaction so part of your child's treatment must be given in a healthcare facility where their provider can monitor and treat them for symptoms of a serious reaction. Palforzia (peanut allergen powder) only available as a brand-name medication, so it can be expensive.
What is Palforzia (peanut allergen powder)?
What is Palforzia (peanut allergen powder) used for?
Lowering the severity of allergic reactions, including a life-threatening reaction, in people with peanut allergies
How Palforzia (peanut allergen powder) works
Palforzia (peanut allergen powder) is a powder that's made from peanut flour and is used as allergen immunotherapy. It's used to lower the chance of anaphylaxis for children with very serious allergic reactions to peanuts. It works by gradually exposing your child to higher doses of peanut protein. This raises your child's tolerance for peanuts, which results in a less severe allergic reaction if they accidentally come in contact with them.
Drug Facts
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What are the side effects of Palforzia (peanut allergen powder)?
Common Side Effects
- Stomach area pain (26-67%)
- Throat irritation (9-40%)
- Vomiting (3-36%)
- Itching (8-33%)
- Nausea (9-32%)
- Cough (3-32%)
- Itchy mouth (9-31%)
Other Side Effects
- Hives
- Runny nose
- Sneezing
- Tingly mouth
- Throat tightness
- Wheezing
- Ear itching
Serious Side Effects
- Very severe allergic reactions: hives, itching, nausea, dizziness, tightness of throat, difficulty breathing, nausea, vomiting, feeling confused or anxious
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heartburn, pain or trouble swallowing, chest pain that does not go away or gets worse
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Burning or tingling of the tongue, mouth, throat, or face
- Irritation inside the mouth or throat
- Itching of the mouth, lips, tongue, or ears
- Nausea
- Runny or stuffy nose
- Sneezing
- Stomach pain
Pros and cons of Palforzia (peanut allergen powder)
Pros
Can help lower the chance of a life-threatening allergic reaction to peanuts
Can be started in children as young as 4 years old
After initial dosing, only has to be taken once daily
Good for children who can't swallow capsules since powder must be mixed with semi-solid food
Cons
Not a cure for peanut allergies
Can cause a life-threatening allergic reaction
Initial dosing must be started at a healthcare facility
Only available as a brand medication, so it can be expensive
Must be stored in the refrigerator
Pharmacist tips for Palforzia (peanut allergen powder)
Make sure you and your child are aware of symptoms of an allergic reaction, including hives, rash, tightness in the throat, difficulty breathing, nausea, and vomiting. It's recommended for your child to carry an epinephrine (Epipen) on them at all times and that they know how to use it. Check the epinephrine (Epipen) from time to time to make sure it's not expired.
If you need an epinephrine (Epipen), ask your child's provider to write a prescription. If possible, it's also a good idea to keep an epinephrine (Epipen) at all the places where your child spends a lot of time, such as home and school.
If your child experience any kind of allergic reaction, including stomach-related reactions like nausea and vomiting, let their provider know. Their provider might need change their dose of Palforzia (peanut allergen powder), adjust their treatment plan, or stop Palforzia (peanut allergen powder) altogether.
After initial dosing, each dose of Palforzia (peanut allergen powder) should be taken daily with a meal around the same time each day. It's best to take the medication on a regular schedule. Establishing a routine with dosing can help you avoid missing doses and can help the medication work as best as it can.
Only mix the powder with a small enough amount of food that your child can eat in two or three bites. It's also important that your child eat the mixture right away. If it sits out for too long, the medication can get damaged and might not work as well.
Observe your child for at least 1 hour after giving a dose of Palforzia (peanut allergen powder) because allergic reactions are more likely during this time period.
During the up-dosing phase, don't give your child a dose of Palforzia (peanut allergen powder) at home on the day that you'll be going to your provider's office to start a new dose. This could result in your child getting two doses of the medication.
Don't give a dose of Palforzia (peanut allergen powder) to your child if they've been exercising or have recently had a hot bath or shower. If their body temperature is higher or they have a fast heartbeat, they're more likely to experience a severe allergic reaction after a dose of Palforzia (peanut allergen powder). Wait until your child has cooled down and their heartbeat has gone back to normal before giving the dose. For the same reason, make sure your child doesn't have a hot bath or shower for 3 hours after a dose of this medication.
Store Palforzia (peanut allergen powder) in the refrigerator. Keep the medication in its original package to protect it from moisture.
Frequently asked questions about Palforzia (peanut allergen powder)
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What are the risks and warnings for Palforzia (peanut allergen powder)?
Palforzia (peanut allergen powder) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reaction
*Risk factors: Uncontrolled asthma | Severe allergic reaction to any other food or medication within the past 2 months | *
Palforzia (peanut allergen powder) can cause a severe allergic reaction. The can happen during any phase of treatment, even if your child has tolerated lower doses before. Because of the risk of serious allergic reaction, the initial dosing and each new dose given during the up-dosing phase should be given at a healthcare facility. Your child will need to stay for at least 60 minutes after each dose to be monitored for a severe allergic reaction and receive treatment, if necessary. This medication shouldn't be given if your child has medical conditions that make it difficult for them to survive a serious allergic reaction, such as uncontrolled asthma or during an asthma flare-up.
You should continue to carry an epinephrine pen in case of an allergic reaction during each phase of treatment with this medication. Make sure you know how to use it. Give yourself an epinephrine shot and get medical help right away if you experience signs of an allergic reaction, such as hives, itching, nausea, dizziness, tightness of throat, difficulty breathing.
Must enroll in the Palforzia (peanut allergen powder) REMS program
Because Palforzia (peanut allergen powder) can cause a very serious allergic reaction, you only get this medication through special program called Palforzia (peanut allergen powder) REMS. All healthcare clinics or offices, providers, and pharmacies that are involved in dispensing this medication, as well as those who are receiving treatment, must be register through this medication. The goal is to educate everyone on this potentially life-threatening reaction, and to make sure you and your providers know what to do if this happens. If you're not sure how to enroll in this program, contact your provider.
Allergic condition of the esophagus
Palforzia (peanut allergen powder) can cause an allergic condition called eosinophilic esophagitis. This causes the esophagus to be swollen and irritated. The esophagus can become narrower, which can make it harder to swallow food. It can also lead to a lower appetite, stomach-area pain, and vomiting. Talk to your child's provider if they experience these symptoms while taking Palforzia (peanut allergen powder). They might want your child to stop taking the medication if this condition occurs.
Stomach-related reaction
Palforzia (peanut allergen powder) can cause stomach-area pain, vomiting, nausea, and mouth itching or tingling. If your child experience severe symtpoms and they don't go away, let your child's provider know because they might need to lower their dose of Palforzia (peanut allergen powder).
Palforzia (peanut allergen powder) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| Initial Dose Escalation | 1 dose pack | $48.96 | $48.96 |
| Level 11 Maintenance of 300mg | 1 dose pack | $1271.06 | $1271.06 |
| Level 1 of 3mg | 1 dose pack | $641.52 | $641.52 |
| Level 2 of 6mg | 1 dose pack | $641.52 | $641.52 |
| Level 3 of 12mg | 1 dose pack | $641.52 | $641.52 |
| Level 4 of 20mg | 1 dose pack | $641.52 | $641.52 |
| Level 5 of 40mg | 1 dose pack | $641.52 | $641.52 |
| Level 6 of 80mg | 1 dose pack | $641.52 | $641.52 |
| Level 7 of 120mg | 1 dose pack | $641.52 | $641.52 |
| Level 8 of 160mg | 1 dose pack | $641.52 | $641.52 |
| Level 9 of 200mg | 1 dose pack | $641.52 | $641.52 |
| Level 10 of 240mg | 1 dose pack | $641.52 | $641.52 |
| Level 11 of 300mg | 1 dose pack | $641.52 | $641.52 |
Typical dosing for Palforzia (peanut allergen powder)
When your child starts on Palforzia (peanut allergen powder) they must go through two phases, initial dosing and up-dosing, before they get to a maintenance dose. They'll gradually take higher doses of the medication over about 6 months before they get to a maintenance dose. You can find detailed information about the dosing schedule on the medication's website.
1) Initial dosing must be done in a healthcare facility because of the risk of life-threatening allergic reactions.
Typically, your child will start with 0.5 mg and go up to 6 mg during one office visit. Your child's provider will observe them for 20 to 30 minutes between each dose to see how they react.
2) Up-dosing has to be started within 4 days of the initial dosing.
Typically, your child will start with 3 mg and go up to 300 mg over the course of 6 months. Your child will stay on each dose for 2 weeks before going up to the next highest dose. Your child will take the first dose of each new step in the up-dosing phase in their provider's office. Their provider will observe them for at least 1 hour to see how they react.
3) Maintenance dosing
The typical maintenance dose is 300 mg once daily and is started once your child has finished the up-dosing phase.
How much does Palforzia (peanut allergen powder) cost?
Palforzia (peanut allergen powder) contraindications
Asthma that's not controlled on medication
History of allergic reactions in the esophagus or gut (eosinophilic esophagitis or other eosinophilic gastrointestinal (GI) conditions)
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