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Palforzia

peanut allergen powder
Used for Anaphylaxis
Used for Anaphylaxis

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.

Last reviewed on April 26, 2022
basics-icon

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

Common BrandsPalforzia
Drug ClassAllergen immunotherapy
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$1535.44(save 96.81%)
GoodRx discount
$48.96
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What are the side effects of Palforzia (peanut allergen powder)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

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

Contact your healthcare provider immediately if you experience any of the following.
  • 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:

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

Pros and cons of Palforzia (peanut allergen powder)

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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

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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

Pharmacist tips for Palforzia (peanut allergen powder)

pharmacist
  • 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.

                    faqs

                    Frequently asked questions about Palforzia (peanut allergen powder)

                    What is a REMS program and why is Palforzia (peanut allergen powder) under this program?
                    Since Palforzia (peanut allergen powder) can put your child at risk for serious allergic reactions, it's only available through a special Risk Evaluation and Mitigation Strategy (REMS) program called the Palforzia REMS program. All providers who prescribe Palforzia (peanut allergen powder), pharmacies that dispense the medication, and people who take this medication must be registered with the REMS program. The purpose of this program is to make sure you and your child understand the signs of a severe allergic reaction and what to do if one happens. This can help lower the chance of life-threatening harm if your child experiences a reaction to the medication.
                    Does Palforzia (peanut allergen powder) cure peanut allergies?
                    No, Palforzia (peanut allergen powder) doesn't cure peanut allergies, but it can help make allergic reactions less severe. Even though the medication can make your child less sensitive to peanuts, it's still possible for them to have an allergic reaction. You should continue to be strict about keeping your child away from peanuts. And you should keep an epinephrine (EpiPen) pen with you at all times in case your child accidentally comes in contact with peanuts.
                    What happens if I forget to give Palforzia (peanut allergen powder) to my child?
                    If you forget to give a dose of Palforzia (peanut allergen powder) to your child for 1 to 2 days in a row you can start back with the normal dose once you remember. But you should never give your child two doses in one day to make up for missed doses. If you forget to give your child a dose of Palforzia (peanut allergen powder) for 3 or more days in a row, you should contact their provider before you start giving it again. You might need to go back to the provider's office when your child restarts the medication so they can be monitored for signs of an allergic reaction.
                    How do I prepare a dose of Palforzia (peanut allergen powder)?
                    The lower doses of Palforzia (peanut allergen powder) that your child takes during the initial and up-dosing phases are in capsule form. The maintenance dose is a packet of powder. Your child shouldn't swallow Palforzia (peanut allergen powder) capsules or inhale the powder from the capsules or packet. You should open the capsules or packet and empty the entire contents onto a few spoonfuls of semi-solid food (e.g. applesauce, yogurt, or pudding). The food can be refrigerated or room temperature. Be sure to mix the powder in with the food well. Don't mix the powder with liquid or with hot food. This might damage the medication or affect the way it works. After you're done mixing, throw away the opened capsules or packet and wash your hands right away.
                    Can adults use Palforzia (peanut allergen powder)?
                    Palforzia (peanut allergen powder) is only approved to be started in people ages 4 through 17. You can keep taking this medication if you turn 18 years old during your treatment, unless your provider tells you to stop taking it.
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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.

                    risk-warning

                    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.

                      risk-warning

                      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.

                      risk-warning

                      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.

                      risk-warning

                      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).

                      dosage

                      Palforzia (peanut allergen powder) dosage forms

                      The average cost for 1 dose pack of Level 11 Maintenance of 300mg of Palforzia (peanut allergen powder) is $1271.06 with a free GoodRx coupon. This is 17.22% off the average retail price of $1535.44.
                      dose pack
                      Dose pack
                      DosageQuantityPrice as low asPrice per unit
                      Initial Dose Escalation1 dose pack$48.96$48.96
                      Level 11 Maintenance of 300mg1 dose pack$1271.06$1271.06
                      Level 1 of 3mg1 dose pack$641.52$641.52
                      Level 2 of 6mg1 dose pack$641.52$641.52
                      Level 3 of 12mg1 dose pack$641.52$641.52
                      Level 4 of 20mg1 dose pack$641.52$641.52
                      Level 5 of 40mg1 dose pack$641.52$641.52
                      Level 6 of 80mg1 dose pack$641.52$641.52
                      Level 7 of 120mg1 dose pack$641.52$641.52
                      Level 8 of 160mg1 dose pack$641.52$641.52
                      Level 9 of 200mg1 dose pack$641.52$641.52
                      Level 10 of 240mg1 dose pack$641.52$641.52
                      Level 11 of 300mg1 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.

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                      How much does Palforzia (peanut allergen powder) cost?

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                      contraindications-icon

                      Palforzia (peanut allergen powder) contraindications

                      Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Palforzia (peanut allergen powder) will not be safe for you to take.
                      • 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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