Quick answer: Tennessee does not have a true over-the-counter ivermectin law. Since 2022, Tennessee pharmacists have been able to dispense ivermectin to adults 18 and older without an individual, patient-specific prescription, but only under a collaborative pharmacy practice agreement, meaning a prescriber has already authorized a non-patient-specific order and standardized procedures in advance. A prescriber's authorization sits behind every dispensing decision, even though the patient in front of the pharmacist does not need their own separate prescription.
What Tennessee's Law Actually Allows
Tennessee's law (enacted as SB 2188 and its companion HB 2746, signed by Gov. Bill Lee on April 22, 2022) authorizes a pharmacist to provide ivermectin to a patient 18 or older under a valid collaborative pharmacy practice agreement. That agreement contains a non-patient-specific prescriptive order and standardized procedures that one or more authorized prescribers have already developed and signed off on. In practice, this means a pharmacist can dispense ivermectin without the patient bringing in their own individual prescription, but a licensed prescriber's authorization is still required in the background, built into the agreement the pharmacist operates under.
Collaborative Practice Agreement, Not Over-the-Counter
What "over the counter" usually means. No prescription, no prescriber authorization of any kind behind the sale, and no consultation required before purchase. That is the Idaho model.
What Tennessee's collaborative practice agreement means. A prescriber has already authorized a standardized, non-patient-specific order in advance. The pharmacist dispenses under that pre-existing authorization rather than requiring each individual patient to have their own prescription. A prescriber's decision is still part of the chain; it just happens once, at the agreement level, rather than per patient.
Why the difference matters. These are not interchangeable access models, even though both result in a patient walking out of a pharmacy with ivermectin and no individual prescription in hand. Texas's HB 25 works differently still: a pharmacist is authorized directly by state law and Texas State Board of Pharmacy procedure, without requiring a prescriber's pre-existing non-patient-specific order the way Tennessee's law does. See Is Ivermectin Over the Counter in Texas? for that mechanism specifically, and do not treat the two states' laws as the same thing described in different words.
What This Does Not Change
Tennessee's collaborative practice agreement law does not change the FDA's approved indications for oral ivermectin, which remain intestinal strongyloidiasis and onchocerciasis only. It does not make ivermectin approved for COVID-19, other viral infections, or cancer, in Tennessee or anywhere else. It also does not remove the role of clinical judgment from the process, since a prescriber's standardized procedures and risk-assessment screening sit behind the pharmacist's dispensing decision by design.
Getting Ivermectin in Tennessee Through Telehealth
Tennessee's pharmacist pathway is one option. A licensed telehealth evaluation is a separate path that gives a prescriber the chance to review your specific health history rather than dispense under a standardized, non-patient-specific order. See How to Get Ivermectin for the step-by-step process, and Get an Ivermectin Prescription Online for what an online evaluation specifically involves. Start an intake at 50 Stars Health ivermectin to check eligibility.
Bottom line
- Tennessee's law lets pharmacists dispense ivermectin to adults 18+ without an individual prescription, but only under a collaborative pharmacy practice agreement with a prescriber-authorized standardized order behind it.
- This is not a true over-the-counter model. A prescriber's authorization is still part of the process, at the agreement level rather than the individual-patient level.
- The law dates to 2022 (SB 2188/HB 2746, signed by Gov. Bill Lee, April 22, 2022) and is Tennessee's standing mechanism as of this update.
- Tennessee's mechanism is meaningfully different from Texas's HB 25 and from true OTC states like Idaho; do not treat them as identical.
- Tennessee's law does not change the FDA's approved uses for oral ivermectin or make it approved for COVID-19, other viral infections, or cancer.
Frequently Asked Questions
Is ivermectin over the counter in Tennessee?
Not in the true over-the-counter sense. Tennessee pharmacists can dispense ivermectin to adults 18+ without an individual prescription, but only under a collaborative pharmacy practice agreement that includes a prescriber-authorized standardized order.
What is a collaborative pharmacy practice agreement?
It is an arrangement where a prescriber develops and signs off on a non-patient-specific order and standardized procedures in advance, which a pharmacist then follows to dispense a medication without requiring each individual patient to bring their own prescription.
When did Tennessee's ivermectin law take effect?
Gov. Bill Lee signed the law (SB 2188/HB 2746) on April 22, 2022.
Is Tennessee's law the same as Texas's?
No. Tennessee requires a prescriber-authorized, non-patient-specific order behind every pharmacist dispensing decision, under a collaborative practice agreement. Texas's HB 25 authorizes pharmacists directly under Texas State Board of Pharmacy procedures, without that same collaborative-agreement structure. See Is Ivermectin Over the Counter in Texas? for detail.
Do I still need to see a doctor to get ivermectin in Tennessee?
Not necessarily, under the pharmacist pathway described above. A licensed telehealth evaluation is a separate, also-available path if you want a prescriber to review your specific health history.
Does Tennessee's law mean ivermectin is FDA-approved for more conditions?
No. It changes how ivermectin can be dispensed in Tennessee. The FDA's approved indications for oral ivermectin remain intestinal strongyloidiasis and onchocerciasis only, in every state including Tennessee.
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.
