A handful of states have passed legislation allowing ivermectin to be sold and purchased over-the-counter (OTC) -- and other state legislatures have their sights set on doing the same.
During the pandemic, rampant misinformation drew attention to the antiparasitic as a treatment for COVID, though research continues to show it is not effective against the disease.
Ivermectin tablets are FDA approved at specific doses for treating some parasitic worms, as are topical formulations for some skin conditions and head lice, but neither are FDA approved for preventing or treating COVID. Despite this, an increasing number of states are making it easier to get ivermectin and protecting pharmacists from lawsuits and discipline by licensing boards. None of the laws have information about dosing.
Currently four states -- Tennessee, Arkansas, Idaho, and Louisiana -- have passed OTC ivermectin laws.
In April 2022, Tennessee passed SB 2188/HB 2746, becoming the first state to make ivermectin available OTC. The legislation authorizes "ivermectin suitable for human use" to be sold or purchased OTC "without a prescription or consultation with a pharmacist or other healthcare professional." For 3 years, Tennessee was the only state to have OTC ivermectin.
Then on March 25 of this year, Arkansas passed SB 189, now Act 396. Weeks later, on April 14, Idaho passed similar OTC ivermectin legislation, SB 1211.
Louisiana SB 19, now Act 464, went into effect on June 20, making it the latest state to make ivermectin available OTC. This law specifies that a pharmacist can dispense ivermectin to adults "pursuant to a standing order issued by a healthcare professional with prescriptive authority" and requires the pharmacist to provide the patient with information on indications and contraindications as well as a screening risk assessment tool. For this service, the pharmacy may charge an administrative fee. Ralph Abraham, MD, the state's surgeon general, backed the bill.
In addition to these, other states have bills moving through their legislatures:
Texas
Just this week, 20 Texas House Republicans asked Gov. Greg Abbott (R) to add the reclassification of ivermectin as OTC -- under proposed HB 3219 -- to the agenda for a special session set to begin later this month. Some of these lawmakers have connected the issue to medical freedom.
New Hampshire
A bill with a unique two-fold approach, SB 119, was introduced in May, which lumps together ivermectin access with an unrelated Medicaid provision. The bill would allow pharmacists to follow a standing order from a physician, physician assistant, or advance practice registered nurse to dispense ivermectin alongside an information sheet on side effects. Also included are various protections against disciplinary action for these healthcare professionals.
The paired Medicaid provision "directs pharmacists to dispense brand name drugs to Medicaid beneficiaries when the brand name drug is on the department of health and human services preferred drug list."
North Carolina
The Ivermectin Access Act, or HB 618, was proposed in April 2025. This legislation would direct the state health director "to issue a statewide standing order to allow pharmacists to dispense ivermectin without prescription" as well as "providing immunity from civil or criminal liability" for both the director and any pharmacist who dispenses ivermectin.
Pennsylvania
Also in April, a lawmaker proposed SB 601, which would amend the state's Pharmacy Act to make ivermectin available OTC.
Georgia
In March, SB 366 was first proposed to amend parts of the Official Code of Georgia Annotated related to controlled substances and to pharmacists and pharmacies. This would "provide for ivermectin as an over-the-counter medication in this state" and "remove ivermectin from the definition of, exceptions to, and exemptions from dangerous drugs."
Alabama
A lawmaker brought forth HB 278 in February, which would "permit a physician, a physician assistant, or a certified registered nurse practitioner to give a pharmacist a standing order that has been approved by the State Board of Pharmacy to dispense ivermectin to individuals without a prescription." The standing order would involve a risk assessment protocol and a standardized information sheet
It also has various disciplinary protections for pharmacists and forbids them from participating in "any program or accept anything of value that induces the healthcare provider or pharmacist to affirmatively commend or endorse the use of ivermectin to an individual or the public."
If passed, the legislation would take effect in October of this year.
West Virginia
SB 614 was also introduced in February. The bill would authorize pharmacists to dispense ivermectin without a prescription or consultation and protect them from liability from damages or licensing board discipline.
Missouri
SB 744, which would make both ivermectin and hydroxychloroquine available OTC, was introduced in February, though it has not made much progress. A similar bill, HB 2581, was proposed in January 2024, but never passed.
South Carolina
HB 3916, proposed in February, also aims to make both ivermectin and hydroxychloroquine available without prescription or consultation.
https://www.medpagetoday.com/special-reports/features/116436
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