Palforzia is gone. Stallergenes Greer stopped selling it worldwide on July 31, 2026, six years after it became the first food allergy treatment the FDA ever approved.
If your child was taking it, or if you read about it somewhere on this site and came looking for it, this page explains what happened and what is available now.
What was withdrawn, and why
Palforzia was a standardized peanut protein powder given in slowly increasing daily doses. The idea was not to cure peanut allergy but to raise the amount of peanut a child could be exposed to before reacting, so that an accidental bite at a birthday party was less likely to become an emergency. Children stayed on a peanut-free diet the whole time.
The FDA approved it in January 2020 for ages 4 through 17, and the indication was later widened down to age 1.
The withdrawal had nothing to do with the drug failing. Stallergenes Greer has been consistent that the decision was voluntary and unrelated to safety, quality, or how well the product worked. It was a commercial decision. Bloomberg reported the company walked away less than three years after buying the product from Nestlé.
Two reasons come up repeatedly from allergists who worked with it. The first is the paperwork. Palforzia was sold under a Risk Evaluation and Mitigation Strategy, a restricted access program requiring prescribers, offices, pharmacies, and patients to all be separately certified. Kelly O’Shea, who runs the oral immunotherapy program at the University of Michigan, has said the administrative load was heavy enough that a lot of practices simply never offered it.
The second is timing. Palforzia launched in early 2020 into a pandemic. The treatment depends on long in-office visits for every dose increase, and those visits were exactly what was not happening in 2020. Stephen Tilles, who co-authored the trial that led to approval, has said the shutdowns undermined the support structure that had been built for patients and clinicians.
So a drug that worked never found enough prescribers.
If your child is still taking it
Do not stop on your own, and do not change the dose on your own.
Stopping abruptly can undo the desensitization that took months to build. That is a real loss, not a theoretical one, and it is worth a phone call before anything changes. Anyone still holding supply should be talking to their allergist about how to use it and what comes next.
The good news is that there is a well-trodden path off Palforzia. Once a child is reliably tolerating the 300 mg maintenance dose, roughly the protein in one peanut kernel, many can continue on measured amounts of ordinary store-bought peanut products instead. Tilles has noted that some patients made this switch during their first year on treatment and that it is generally safe. Some peanut products are more consistent in protein content than others, which is one of several reasons this transition belongs in an allergist’s office rather than a kitchen.
Nobody should attempt this at home unsupervised. Dosing errors in oral immunotherapy cause reactions.
What is available now
Office-based oral immunotherapy. Some allergists run peanut OIT using carefully measured peanut flour or standardized food products rather than a branded pharmaceutical. These protocols are not FDA-approved, and insurance coverage is inconsistent. The clinical logic is the same as Palforzia’s, and much of what is known about how to run these protocols safely came out of the Palforzia trials.
Xolair (omalizumab). An injection given every two to four weeks that blocks IgE, the antibody driving the allergic response. The FDA approved it in February 2024 to reduce allergic reactions to accidental exposure across multiple food allergens, in adults and children from age 1. It is not a cure and it does not treat a reaction in progress. Unlike oral immunotherapy, the protection generally fades once you stop the injections.
Avoidance, plus epinephrine. Still the foundation under everything else. Anyone with a peanut allergy needs a current, in-date epinephrine auto-injector with them, and needs to know how to use it. The options now include EpiPen, Auvi-Q, and neffy, which is given as a nasal spray rather than an injection.
Antihistamines have a role in mild symptoms and after epinephrine has been given, but they do not treat anaphylaxis and should never be the plan for it.
What is coming
Tilles does not expect another FDA-approved oral immunotherapy product soon. The development and regulatory costs are high, and Palforzia’s commercial run is not an encouraging precedent for anyone considering it.
Other work continues. Omlyclo, a biosimilar version of Xolair, is expected to launch in late 2026. GSK bought RAPT Therapeutics in January 2026 for an anti-IgE therapy in early trials that would need dosing only every twelve weeks. Sublingual immunotherapy for peanut has produced encouraging study results.
The peanut patch, Viaskin, gets asked about a lot. It cleared its Phase 3 trial, but as of mid-2026 the manufacturer has still not filed it with the FDA, with submission expected later this year. It is not available, and there is nothing patients need to do about it yet.
Where we stand
We offer office-based peanut oral immunotherapy at NY Allergy & Sinus Centers, and losing Palforzia does not change that.
What it does change is the paperwork around it. Palforzia came with FDA approval, a standardized product, and a clearer path through insurance. Office-based OIT has none of those. The treatment is not FDA-approved, coverage varies from plan to plan, and every dose increase happens here rather than at a pharmacy counter. That is a fair amount to take on, and it is worth going in with your eyes open.
The treatment itself has not changed much. You take small, measured, gradually increasing amounts of peanut protein under supervision, with the goal of raising the amount you can be exposed to before you react. It is not a cure. You keep avoiding peanuts and you keep carrying epinephrine, during treatment and after.
Whether OIT is a good idea for you depends on things we can only work out in a room together. Your reaction history matters. So does asthma control, and whether you have eosinophilic esophagitis, and honestly how much daily dosing your household can realistically sustain. For some families the answer is that avoidance plus a solid emergency plan is the better call, and we will tell you if we think that.
If you or your child were taking Palforzia, come in and bring whatever records you have, including the dose you were on. That number matters for working out what comes next.
Common questions
Was Palforzia recalled? No. A recall means a safety or quality problem. This was a voluntary business decision to stop selling the product, and the manufacturer has said it was unrelated to safety, quality, or efficacy.
Is peanut allergy treatment over? No. Palforzia was the only FDA-approved oral immunotherapy for peanut, but oral immunotherapy itself continues in allergists’ offices using other peanut products, and Xolair remains approved for IgE-mediated food allergy.
Will my child lose the protection they built up? Not necessarily, if the transition is managed. Desensitization depends on continued regular exposure, which is why abrupt stopping is the thing to avoid. Talk to your allergist before making any change.
Can I just give my child peanut products at home instead? No. The dose matters, the product consistency matters, and reactions happen. This has to be supervised.
Does this change anything about school? No. Your child still needs an epinephrine auto-injector at school, a current emergency action plan, and staff who know the plan. That was true on Palforzia and it is true now.
Talk to us about peanut allergy treatment
If your child was on Palforzia, or you have been waiting to look at treatment options, we can go through what makes sense for your situation.
Book online or call (212) 686-6321 to schedule your appointment.