There are three stages.
Stage 1 – initial dose escalation – you receive increasing doses of peanut flour in clinic, under our supervision, every 30 minutes until you have taken 5 doses. These are very small doses. We expect most people to have no problems with this first day of treatment.
For the next 2 weeks, you take a precise dose of peanut flour (measured by us) at home, once a day with food.
Stage 2 – called “updosing”. Every 2 weeks, you come back to us to see if you are ready for a new, slightly higher dose.
If everything is going well, you get a new higher strength dose and we observe you for at least 60 minutes before you can go home. We would aim to to do this in the afternoon so you don’t need to miss school.
You continue to take your dose of peanut flour at home every day. After two weeks, you come back to us for a new, slightly higher strength dose.
We repeat this process, where you take your daily dose at home and come back every 2 weeks for a new dose, for about 6 months.
Stage 3 – after 6 months of treatment, once you can take the 300mg daily maintenance dose safely, you have reached stage 3. You continue to give the same 300mg dose of peanut flour at home for at least 3 months. After that, at a time agreed with you, we can switch from peanut flour to an alternative form of peanut (such as peanut butter, Bamba or peanut M&Ms).
How and when should my child take their dose of peanut flour?
- Your child will need to take the dose of peanut flour every day, at roughly the same time each day. With their evening meal is best.
- We provide it in capsule form – you do not swallow the capsule! Capsules should be opened and the powder emptied and mixed into a small amount of food (nothing hot or too watery). Use a food that your child likes and that can be eaten easily in one sitting – rice pudding, fruit puree or yoghurt would be good.
- Things like milk, soup and smoothies would not be appropriate.
- Try to avoid your child running around or doing exercise right before, or for 3 hours after, they take their dose of peanut flour.
- Avoid a hot bath or shower right before, or for 3 hours after, they take their dose of peanut flour.
- They should wait at least two hours after taking their dose of peanut flour before they go to sleep.