Is ivermectin over the counter?

What "OTC" means here

Behind the counter, not on the shelf. You ask at the pharmacy counter, answer a few questions, and the pharmacist decides.

People sometimes compare it to cold medicine with pseudoephedrine, which is also kept behind the counter. The comparison only goes so far. Pseudoephedrine is a nonprescription drug with purchase limits. Oral ivermectin stays a prescription drug under federal law, and the state law gives the pharmacist authority to dispense it to an adult without a prescription written for that person.

So in practice, "ivermectin OTC" means a pharmacist in one of a few states can hand it over after a short screening. Everywhere else it means nothing has changed.

Legal to buy is not the same as approved to treat

A state law changes who may dispense ivermectin. It doesn't change what the FDA has reviewed it for.

The FDA label for ivermectin tablets covers two parasitic infections: strongyloidiasis of the intestinal tract and onchocerciasis (river blindness). That's what the drug was tested and approved for. The topical forms, a lotion and a cream, are separate products with their own labels.

None of the state laws add approved uses or say anything about how well ivermectin works for a given condition. Whether it fits your situation is a question for the pharmacist or your doctor, and either of them can say no.

Why your local CVS or Walgreens may say no

The laws say a pharmacist may dispense ivermectin without a prescription. They don't say a pharmacist shall.

That one word leaves the choice with each pharmacy and each pharmacist. A chain can decide not to stock it, a store can be out of it, and a pharmacist can decline after the screening. None of that breaks the law. We can't tell you any particular chain's policy, and it can differ from one store to the next, so call ahead before you drive over.

States with bills pending

Bills have been filed in other legislatures. A bill isn't a law until it passes and takes effect, so we don't count those states.

We keep a dated watch list of pending ivermectin bills and move a state into the table above only once its law is in force. If you live in one of those states, the prescription route is the one that applies today.

What the pharmacist will ask

Enough to decide whether ivermectin is safe for you. Our checkout questionnaire asks the same things a pharmacist would at the counter.

• Your date of birth (you must be 18 or older) and your weight in pounds.
• Whether you're pregnant, breastfeeding or planning a pregnancy.
• Allergies, and every medicine you take. Blood thinners such as warfarin, seizure medicines and sedatives get a specific question.
• Whether you have liver disease.
• Why you want it, and whether a clinician has diagnosed a parasitic infection.
• Confirmation that you live in the state you're ordering for.