No. As of September 2026, ivermectin is not available over the counter in South Dakota. Oral ivermectin tablets are still a federal prescription-only drug, and South Dakota has not passed any law that lets a pharmacy hand them to you without a prescriber's involvement. If you want the human-labeled tablets in Sioux Falls, Rapid City, Aberdeen or anywhere else in the state, you need a valid prescription from a licensed clinician — the same rule that applied before the pandemic. For background on how the rules differ from state to state, see our overview of non-prescription ivermectin access.

South Dakota came close in early 2026. House Bill 1068 would have allowed pharmacists to dispense ivermectin (and hydroxychloroquine) to adults under a written protocol, but the bill failed on the House floor on February 5, 2026, by a 28–40 vote. That means the state's answer for now is unchanged, and any page telling you otherwise is out of date. Our state-by-state notes on finding ivermectin at a pharmacy explain what a prescription-only state looks like in practice.

Key takeaways

  • Ivermectin tablets require a prescription in South Dakota. There is no pharmacist-dispensing or OTC carve-out in state law as of September 2026.
  • House Bill 1068 (2026) would have created a protocol-based dispensing pathway for adults 18 and older. It was defeated in the House, 28–40, on February 5, 2026.
  • The FDA still classifies oral ivermectin as prescription-only, approved for specific parasitic infections — not for COVID-19, flu or cancer.
  • Veterinary ivermectin sold at farm and ranch stores is labeled for animal use only and is not approved for people.
  • With a prescription, generic ivermectin is inexpensive: GoodRx lists coupon prices starting around $22.66 against an average retail price near $36.55 for ten 3 mg tablets.

Is ivermectin available over the counter in South Dakota?

A pharmacist counts small white tablets on a stainless steel tray, illustrating prescription-only dispensing rules for ivermectin in South Dakota.

It is not. Two things have to line up before a drug can be sold off the shelf: federal classification and state law. Neither one currently permits over-the-counter ivermectin in South Dakota.

At the federal level, oral ivermectin remains a prescription product. The FDA has approved it for certain parasitic infections — intestinal strongyloidiasis and onchocerciasis (river blindness) — and separately approves topical ivermectin for head lice and rosacea. The agency has stated it has not authorized or approved ivermectin for preventing or treating COVID-19 in humans or animals. A June 2025 citizen petition asked the FDA to switch ivermectin tablets to OTC status, citing state-level laws as supporting evidence, but a pending petition does not change a drug's legal status.

At the state level, a handful of legislatures have created their own carve-outs. Pharmacy Times reported that, as of July 10, 2025, four states had passed laws allowing OTC distribution: Tennessee was first in 2022 with SB 2188/HB 2746, Arkansas followed with SB 189/Act 396 on March 25, 2025, and Idaho passed SB 1211 on April 14, 2025, with Louisiana also enacting a law. South Dakota is not on that list. Readers comparing neighbors and other states may find our pages on the situation just across the border in North Dakota and on Alabama's approach to ivermectin access useful, since the statutory wording varies quite a bit.

What the South Dakota law actually allows (pharmacist dispensing, age limits, effective date)

A gloved hand holds a plastic veterinary paste syringe, a product labeled for animal use only and not approved for people.

South Dakota law allows what it has always allowed: a licensed physician, physician assistant or nurse practitioner may prescribe ivermectin, including off-label, using their clinical judgment, and a pharmacist may fill that prescription. Off-label prescribing is lawful in every state; it means the FDA has not reviewed that specific use, not that the use has been shown to work.

What HB 1068 would have done

The 2026 bill, sponsored by Rep. Bobbi Andera of Sioux Falls with Sen. Greg Blanc of Rapid City as lead Senate sponsor, was narrower than a true OTC law. As engrossed, it would have added a section to chapter 36-11 permitting a pharmacist to dispense ivermectin or hydroxychloroquine to an individual eighteen years or older in accordance with a written protocol developed by a licensed health care provider containing a non-patient-specific prescriptive order. That protocol would have had to give the patient a screening risk assessment tool for each drug plus information on indications and contraindications, the appropriate method for using the drug, and evaluating and treating adverse events, with the pharmacist keeping a copy of the protocol on file. A companion section would have shielded a physician acting in good faith from criminal, civil or disciplinary action by the State Board of Medical and Osteopathic Examiners, except where the conduct amounted to gross negligence or willful misconduct.

Why there is no effective date

Because the bill failed, none of the above is law and there is no effective date. House Health and Human Services voted 8–5 to pass it amended on February 3, 2026, but the full House rejected it 28–40 on February 5, 2026. One opponent called it a "COVID hangover bill," and the measure drew opposition from a long list of health organizations. Committee minutes list opponents including the South Dakota Board of Pharmacy, the Department of Health, the South Dakota Pharmacists Association, the South Dakota State Medical Association, Avera Health, Sanford Health and Monument Health. This is not South Dakota's first attempt: a 2022 bill, HB 1267, passed the House but died in Senate committee.

Prescription vs. pharmacist-dispensing vs. true OTC

Model What it means South Dakota status
Prescription only A clinician must evaluate you and write a prescription Current law
Pharmacist dispensing under protocol Pharmacist screens and dispenses under a standing protocol; no individual visit Proposed in HB 1068; failed
True OTC sale Sold from a shelf with no prescription or consultation Not permitted

Where to buy ivermectin locally in South Dakota

A laptop angled away during a telehealth video visit with a notepad, pen and amber medicine vial in the foreground.

With a prescription, human ivermectin tablets are stocked or orderable through ordinary retail and health-system pharmacies across the state — chains, grocery pharmacies, independents, and the outpatient pharmacies attached to Sanford, Avera and Monument Health. Generic ivermectin 3 mg is a common product, but small-town pharmacies may not keep it on the shelf; calling ahead is worth the two minutes, since most can order it for next-day pickup.

Two kinds of products you will see in South Dakota are not substitutes for a prescription:

If a website offers to ship human ivermectin tablets to a South Dakota address with no prescription and no clinician contact, that is a signal to walk away — you have no assurance of what is in the package. Our guidance on how to evaluate online pharmacies safely covers the verification steps to use instead.

If you still need a prescription: telehealth options

Coins, small bills and an amber vial of white tablets arranged on a counter to illustrate what ivermectin costs with a prescription.

Because South Dakota requires a prescription, a telehealth visit is the realistic path for most people who do not already have an appointment. Any clinician licensed in South Dakota may evaluate you by video or phone and prescribe if they judge it appropriate; the prescription then goes electronically to a pharmacy you choose.

Practical points worth knowing:

  • The prescriber must generally be licensed in South Dakota, not only in their home state.
  • General-purpose telehealth services — including the virtual care arms of the state's health systems and national platforms — handle parasitic-infection questions routinely. Ivermectin is a normal prescription in that context when there is a parasitic diagnosis such as scabies or strongyloidiasis.
  • A clinician may decline. For COVID-19 or other respiratory illness, many will, because the FDA has not approved ivermectin for viral illness and large randomized trials — including ACTIV-6 and TOGETHER — did not find a meaningful benefit for COVID-19 outcomes.
  • Be cautious with sites that promise a prescription before any assessment, charge a flat "membership" fee for guaranteed approval, or ship from overseas. A legitimate visit can end without a prescription.

What it costs in South Dakota

Generic ivermectin is cheap by US drug-pricing standards, and South Dakota prices track national ones. GoodRx reports an average cost of $22.66 for ten 3 mg tablets with a free coupon, about 38% off an average retail price of $36.55. For the most common version overall, GoodRx lists coupon pricing starting near $22.66 against an average retail price of $69.54. Drugs.com puts the cash price for twenty 3 mg tablets at roughly $77, with twenty 6 mg tablets starting around $227 for cash-paying customers.

Topical ivermectin is a different cost picture. GoodRx lists Soolantra (topical ivermectin for rosacea) at an average retail price of $328.58, with coupon pricing around $92.67.

Item Typical figure Source
Ivermectin 3 mg, 10 tablets (coupon) ~$22.66 GoodRx
Ivermectin 3 mg, 10 tablets (avg. retail) ~$36.55 GoodRx
Ivermectin 3 mg, 20 tablets (cash) ~$77 Drugs.com
Telehealth visit Varies; commonly $0–$100 depending on plan and platform —

Ivermectin is covered by many commercial plans, Medicare Part D plans and South Dakota Medicaid when prescribed for an approved indication. Coverage for off-label use is far less predictable, and a denied claim leaves you paying cash — in which case a discount card often beats the insurance price outright. Prices in this section were checked in September 2026 and change without notice.

Frequently asked questions

Can a South Dakota pharmacist give me ivermectin without a prescription?

No. That is precisely what HB 1068 would have authorized for adults 18 and older, and the House rejected it 28–40 on February 5, 2026. Without that law, a pharmacist needs a valid prescription.

Could South Dakota pass an ivermectin law in a future session?

It is possible. A similar bill died in 2022 and another failed in 2026, and other states have continued to introduce legislation. Any change would come through the Legislature and, for implementation details, the South Dakota Board of Pharmacy. Check the South Dakota Legislature site for current bills rather than relying on older articles.

Is it legal to take horse paste ivermectin instead?

Buying veterinary ivermectin is legal; those products are labeled for animal use only and are not approved for human use. Concentrations are formulated for large animals, inactive ingredients have not been tested in people, and dosing by eye has led to poisoning reports. The FDA advises against using animal medications on people.

Does ivermectin treat COVID-19, flu or cancer?

The FDA has not approved ivermectin for any viral illness or for cancer, and it states that it has not authorized or approved ivermectin for preventing or treating COVID-19. Large randomized trials of ivermectin for COVID-19 did not show a meaningful clinical benefit. Evidence for cancer use in humans is absent, not merely mixed.

Can I drive to another state to buy it over the counter?

Some states permit non-prescription sale, but a pharmacy generally applies the law of the state it operates in, and out-of-state purchases raise questions about follow-up care, interactions and product authenticity. Nothing in South Dakota law recognizes an out-of-state OTC purchase as a substitute for a prescription.

When were the facts on this page last verified?

Legislative status, FDA classification and pricing were verified in September 2026. State drug laws have changed repeatedly since 2022, so confirm current status with the South Dakota Legislature, the South Dakota Board of Pharmacy or your pharmacist before acting.

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