Palforzia Discontinued, Ending the Only FDA-Approved Peanut OIT Option

Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia), the first and only FDA-approved oral immunotherapy (OIT) for peanut allergy, will be discontinued as of July 31, 2026, leaving allergists without an FDA-cleared product for patients starting desensitization.1

Stallergenes Greer has said the withdrawal is not related to safety, quality, or efficacy.1 Robert Wood, MD, of Johns Hopkins University, said the drug's rocky commercial run began almost immediately after its 2020 approval.

"It got off to a very unfortunate start because it was approved in January of 2020, and the pandemic started in March of 2020," Wood said.

Why Palforzia Struggled After Approval

Palforzia's in-office dose buildups became difficult to schedule once pandemic restrictions took hold, Wood said, and cumbersome FDA prescribing requirements added friction for practices. During the same period, more allergists gained comfort compounding peanut OIT from grocery store products, drawing volume away from the branded therapy.

Palforzia's studies also documented roughly a 10% risk of anaphylaxis in the first 1 to 2 years of treatment, along with a subset of patients who discontinued due to severe gastrointestinal effects, including eosinophilic esophagitis.

What Allergists Should Tell Patients Now

For patients already at maintenance dosing, transition risk is low. Palforzia's maintenance dose delivers approximately 300 mg of peanut protein, providing cross-contamination coverage against accidental ingestion, said Jacqueline Ross, MD, of Allergy Partners of New Jersey.

Beyond OIT, Ross pointed to a broadening menu of options: omalizumab is now FDA-approved for food allergy, sublingual immunotherapy data continue to accumulate, and epicutaneous immunotherapy remains in active study.

“Very few people out there are going to be missing Palforzia as a treatment option, because those who want to do peanut OIT will continue to do it with products purchased in the grocery store,” Wood said.

References

1. With Palforzia® Ending, What's Next For Peanut Allergy Patients? Allergy & Asthma Network. Published February 19, 2026. Accessed July 30, 2026. https://allergyasthmanetwork.org/news/palforzia-discontinued/

2. Stallergenes Greer. Palforzia. Accessed July 30, 2026. https://www.palforzia.com/