In recent years, Ivermectin has become one of the most talked-about medications in the United States. Originally developed and approved as an anti-parasitic drug, it became a household name during the COVID-19 pandemic, albeit controversially. While Ivermectin was traditionally a prescription-only medication, changes in regulation and growing demand have now led some U.S. states to allow over-the-counter OTC Ivermectin access under specific conditions.

So, what does this mean for the average consumer? Let’s dive deep into the world of Ivermectin, explore its uses, the reasons behind this regulatory shift, and the implications for public health.

A Brief History of Ivermectin

Ivermectin was first introduced in the late 1970s and became famous for its effectiveness in treating parasitic infections like river blindness and intestinal worms. It earned its creators the Nobel Prize in Physiology or Medicine in 2015. Safe, cheap, and accessible, it remains a vital medication in many parts of the developing world.

Traditionally, Ivermectin in the United States was prescribed to treat:

• Onchocerciasis (river blindness)
• Strongyloidiasis (a type of roundworm infection)
• Scabies
• Head lice

Veterinary forms of Ivermectin are also widely used to treat parasites in animals. However, it’s important to note that human-use Ivermectin is formulated differently and at different dosages than the veterinary versions.

Ivermectin and COVID-19: A New Chapter

The COVID-19 pandemic catapulted Ivermectin into the spotlight. Some early laboratory studies suggested that it might inhibit the replication of the SARS-CoV-2 virus. This led to a surge in off-label use by individuals hoping to prevent or treat COVID-19.

While the FDA and CDC have been clear that Ivermectin is not approved for COVID-19 prevention or treatment, anecdotal reports and smaller, non-peer-reviewed studies fueled public interest. This created a huge demand, causing shortages and a wave of misinformation.

In response, health authorities cautioned against self-medication and misuse, especially with veterinary-grade Ivermectin. However, the conversation around access to Ivermectin didn’t die down — it evolved.

The Shift to OTC ivermectin Availability

As the dust of the pandemic settled, some U.S. states began to reconsider how they regulate access to certain medications, including Ivermectin. In states such as Tennessee and New Hampshire, laws and regulatory guidance now allow Ivermectin to be sold over the counter in pharmacies under specific frameworks.

For instance:

• In Tennessee, legislation was passed allowing pharmacists to dispense Ivermectin without a traditional prescription after providing patient counseling.
• In New Hampshire, a similar approach enables pharmacists to sell Ivermectin directly under a standing order, reducing barriers for consumers.

This shift reflects a broader movement toward medical freedom and patient choice, emphasizing that individuals should have greater control over their healthcare decisions — especially when dealing with safe, well-known medications like Ivermectin.

States Where Ivermectin Is Available Over the Counter

1. Idaho

In April 2025, Idaho Governor Brad Little signed Senate Bill 1211 into law, permitting the sale of ivermectin over the counter without a prescription or consultation with a healthcare professional. ​

2. Arkansas

Arkansas passed legislation in March 2025 allowing ivermectin suitable for human consumption to be sold over the counter, eliminating the need for a prescription or healthcare consultation. ​

3. Tennessee

Tennessee enacted a law in 2022 enabling pharmacists to dispense ivermectin without a prescription under a standing order. Pharmacists are required to provide a standardized factsheet and conduct a screening risk assessment.

States Considering OTC Legality of Ivermectin

1. North Carolina

In April 2025, North Carolina lawmakers introduced the Ivermectin Access Act, aiming to make ivermectin available over the counter at pharmacies without a prescription.

2. Pennsylvania

A proposal is underway in Pennsylvania to allow over-the-counter access to ivermectin, focusing on increasing accessibility for treating parasitic conditions.

3. South Carolina

In February 2025, South Carolina legislators introduced a bill to authorize the over-the-counter sale of ivermectin tablets and hydroxychloroquine tablets. ​

4. Oklahoma

Oklahoma lawmakers proposed Senate Bill 426 in February 2025 to permit the over-the-counter sale of ivermectin. ​

States That Have Rejected OTC Ivermectin

New Hampshire

Legality of ivermectin In 2022, the New Hampshire House approved legislation to allow pharmacists to dispense ivermectin via standing order. However, Governor Chris Sununu vetoed the bill, preventing it from becoming law. ​

Important Considerations

• FDA Approval: The U.S. Food and Drug Administration (FDA) has not approved ivermectin for the prevention or treatment of COVID-19. It remains approved for specific parasitic infections.​
• Safety: While ivermectin has a long-standing safety record for approved uses, misuse or overdose can lead to serious health risks. Consulting with a healthcare professional before use is strongly recommended.​
• Pharmacist Guidance: In states where OTC sales are permitted, pharmacists may provide counseling to ensure safe and appropriate use.

Why Some States Are Allowing OTC Ivermectin

Several factors contributed to this decision:

• Long safety record: Ivermectin has been used for decades with an excellent safety profile when used correctly.
• Public demand: Many consumers sought easier access without having to obtain a prescription.
• Cost-effective healthcare: Allowing OTC access could reduce the burden on the healthcare system, saving time and money.
• Response to COVID controversies: In reaction to what many viewed as heavy-handed regulation during the pandemic, some states moved to empower individuals and pharmacists.

Importantly, OTC Ivermectin is still dispensed with guidance from pharmacists to ensure it is used safely and appropriately.

Potential Risks and Concerns

While the move to OTC availability is celebrated by some, it also raises concerns among public health officials:

• Self-medication risks: Individuals might take incorrect doses or use it for unapproved conditions.
• Misinformation: Misuse could result from misunderstanding its true indications and limits.
• Drug interactions: As with any medication, Ivermectin can interact with other drugs, which pharmacists must monitor carefully.

Still, proponents argue that similar risks exist with many OTC drugs, from acetaminophen to cold medications, and that with proper counseling, these risks are manageable.

What Consumers Should Know Before Buying OTC Ivermectin

If you live in a state where Ivermectin is available OTC, here are a few important points to consider before you buy ivermectin online:

• Consult a pharmacist: Even though you don’t need a prescription, ask for advice on correct dosing and potential side effects.
• Use human formulations only: Never use veterinary Ivermectin intended for animals.
• Understand the approved uses: Ivermectin is primarily for parasitic infections, not for viruses unless new evidence emerges.
• Be wary of online sources: Stick to legitimate pharmacies to avoid counterfeit or unsafe products.

The availability of OTC Ivermectin marks a fascinating turning point in American healthcare. It reflects evolving attitudes toward patient autonomy, drug accessibility, and pharmaceutical regulation.

While it’s not a magic bullet for every illness — and particularly not a proven treatment for COVID-19 — Ivermectin remains a powerful and important medication when used appropriately. With careful oversight from pharmacists and informed decision-making by consumers, this new availability could make Ivermectin an even more accessible tool in the fight against parasitic diseases.

As more states watch and learn from the early adopters, it’s possible we’ll see even broader access across the country in the coming years.