By the 50 Stars Health Editorial Team
Last updated: September 2026. This page is reviewed quarterly as state laws change. Every state claim below is sourced; if we can't verify a state, we leave it off rather than guess.
The Federal Baseline (Read This First)
Oral ivermectin remains a prescription-only medication under federal law nationwide, and the FDA has not approved it for over-the-counter sale (FDA-approved Stromectol drug label, accessdata.fda.gov). The FDA has also stated that it has not approved ivermectin to prevent or treat COVID-19 or any other viral infection. The state laws below change who can dispense ivermectin within a state, typically by expanding pharmacist authority. They do not change the FDA's approval status or ivermectin's approved uses.
States That Have Passed Laws Allowing Pharmacist-Dispensed or OTC Ivermectin
Tennessee (SB 2188 / HB 2746), effective April 22, 2022. Pharmacists may dispense ivermectin to adults 18+ without an individual prescription, under a collaborative pharmacy practice agreement with a prescriber. Sources: Chattanooga Times Free Press; bill text via Trackbill.
Idaho (SB 1211), effective April 2025. Full over-the-counter sale, with no prescription or provider consultation required. The bill carried an emergency clause, so it took effect on signature. Source: Idaho Capital Sun.
Arkansas (Act 396 / SB 189), signed March 2025 and effective approximately 90 days after legislative adjournment (around August 2025). Over-the-counter sale, with no prescription or consultation required. Sources: Official Act 396 text, Arkansas General Assembly; Arkansas Democrat-Gazette.
Louisiana (Act 464), law effective June 20, 2025, with the statewide standing order issued September 24, 2025. Pharmacists may dispense to adults 18+ under a statewide standing order issued by a Louisiana Department of Health prescriber. This is not a fully unrestricted OTC model. Source: Louisiana Board of Pharmacy bulletin.
Texas (HB 25), effective December 4, 2025. Pharmacists may dispense without an individual prescription, following standardized procedures set by the Texas State Board of Pharmacy, including a required discussion of possible side effects. HB 25 was enacted during the 89th Legislature's second special session, so it does not follow the regular session's typical September 1 effective date. Sources: KXXV; News From The States.
Iowa (HF 2676, the Iowa MAHA Act), effective July 1, 2026 and in effect as of this update. Pharmacists and pharmacies may distribute ivermectin for human use without a prescription drug order, as part of a broader health policy bill signed by Gov. Kim Reynolds. Sources: Iowa Capital Dispatch, April 27, 2026; Iowa Legislature, HF 2676 bill record.
Note on service area: 50 Stars Health does not currently serve Arkansas. Arkansas's OTC law is reported above regardless, because this page reports the law accurately whether or not we operate there.
States With Pending Legislation (Not Yet Law)
- Oklahoma: HB 4124 would allow pharmacists to dispense ivermectin without a prescription. It advanced out of a House committee in February 2026 but has not been signed into law as of this update (Oklahoma House of Representatives).
- New Hampshire: A similar provision was added to SB 119, but the bill did not pass and its status was recorded as dead as of June 2025 (New Hampshire Bulletin).
Additional states introduce similar bills most legislative sessions. We add a state to the enacted list above only once we can verify a signed law or an official effective date from a primary or authoritative source, not from a bill's introduction or a single committee vote.
What These Laws Do Not Change
- They don't change the FDA's approved indications for oral ivermectin: intestinal strongyloidiasis and onchocerciasis only.
- They don't make ivermectin approved for COVID-19, other viral infections, or cancer, in any state.
- They don't remove the value of a clinical evaluation. Ivermectin still carries risks and potential drug interactions that a licensed provider is best positioned to review, regardless of whether your state requires a prescription to buy it.
Does 50 Stars Health Serve My State?
Service area and state dispensing law are two different questions. A state passing a pharmacist-dispensing law doesn't necessarily mean 50 Stars Health serves it, and a state without such a law doesn't mean our telehealth evaluation isn't available there. 50 Stars Health's ivermectin telehealth evaluation is available in most states; check yours during intake at 50 Stars Health ivermectin. For the evaluation process itself, see How to Get Ivermectin and Ivermectin Prescription Online.
How We Keep This Page Accurate
We source every state claim to a primary source (state legislature or state board of pharmacy documents) or corroborating reputable news coverage, and we review this page quarterly. If a state's law changes or we find an error, we update the state list and the "last updated" date above. If you're a journalist or researcher and spot something outdated, our sourcing is linked so you can verify independently.
Frequently Asked Questions
Which states allow ivermectin without a prescription?
As of September 2026, Tennessee, Idaho, Arkansas, Louisiana, Texas, and Iowa have each passed laws allowing pharmacist-dispensed or over-the-counter ivermectin access without a patient-specific prescription. The exact model (full OTC vs. standing order vs. collaborative practice agreement) varies by state; see the state-by-state breakdown above.
Does a state OTC ivermectin law mean the FDA approved it for over-the-counter sale?
No. These are state-level changes to pharmacist dispensing authority. The FDA still classifies oral ivermectin as a prescription medication nationally and has not approved it for OTC sale or for COVID-19, other viral infections, or cancer.
Is ivermectin legal in my state?
It depends on your state. If your state isn't listed among the enacted laws above, ivermectin is most likely still available only by prescription there. Check your state's board of pharmacy for the current rule.
What's the difference between "over the counter" and "pharmacist-dispensed" ivermectin?
"Over the counter" generally means no prescription or provider consultation is required at all, as in Idaho and Arkansas. "Pharmacist-dispensed" models, like Louisiana's standing order or Tennessee's collaborative practice agreement, still involve a healthcare professional's authorization behind the pharmacist's dispensing decision.
How often is this page updated?
We review it quarterly and update it sooner if a state law changes. The "last updated" date at the top of this page reflects the most recent review.
Can I still get ivermectin through telehealth if my state doesn't have an OTC law?
Yes. A licensed telehealth provider can evaluate your case and prescribe ivermectin if appropriate, independent of whether your state has passed a pharmacist-dispensing law. See Ivermectin Prescription Online.
Why do state ivermectin laws keep changing?
State legislatures have been actively introducing and passing bills on pharmacist dispensing authority for ivermectin since 2022, and more states consider similar bills each session. That's why this page is reviewed quarterly rather than written once and left alone.
This page is for general educational purposes only and is not medical advice, nor a substitute for consultation with a licensed healthcare provider. Ivermectin is a prescription medication approved by the FDA to treat certain parasitic infections. It is not approved to prevent or treat viral infections or cancer. Only a licensed provider can determine whether a treatment is appropriate for you, and prescriptions are issued at the provider's discretion following a clinical evaluation. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or manufacturing quality. If you believe you may have a parasitic infection, speak with a healthcare provider. Do not self-treat. In an emergency, call 911.
This page summarizes publicly available state legislation and regulatory actions concerning ivermectin dispensing. It is provided for general informational purposes only and is not legal advice, and it should not be relied on as a substitute for consultation with a licensed attorney or your state board of pharmacy. Laws change frequently, vary by state, and may be amended, challenged, or reinterpreted after this page's last update. Confirm current requirements with your state board of pharmacy before acting on anything summarized here.
