Ivermectin Laws by State: All 50 States and DC, With the Record for Each

7 states have an enacted law that lets a pharmacy supply human ivermectin without a patient-specific prescription. Most reporting gives a different number, because most reporting counts protection laws as access laws. They are not the same thing, and this table keeps them apart.

The four mechanisms, and why the difference matters

A reader wants to know one thing: can I get it, and what do I have to do. The answer depends on which of four legal routes a state used, and they are not interchangeable.

Over-the-counter sale

The statute lets ivermectin be sold or purchased as an over-the-counter medicine. No prescription and no practitioner consultation. It is still normally kept behind the pharmacy counter.

Pharmacist protocol

A pharmacist may dispense without a prescription, following written standardized procedures issued by the state board of pharmacy. No practitioner is involved, but a pharmacist is.

Collaborative agreement

A pharmacist dispenses under a collaborative pharmacy practice agreement with a non-patient-specific prescriptive order. Usually limited to adults.

Physician standing order

Dispensing under a standing order issued by a named prescriber or a state health department. Usually limited to adults.

Protection law only

The law protects a prescriber or pharmacist from discipline or liability. It creates NO new way to obtain the drug. A prescription is still required. These laws are routinely miscounted as access laws.

Every state and the District of Columbia

Sorted alphabetically. Every row links to the record it rests on: a legislature's own bill page, an enrolled act, a codified statute or a board of pharmacy. Last full check September 27, 2026.

Who actually stands between you and the drug

This is the question most coverage skips. Of the 7 states with a law, 2 let you buy it with nobody in the way: Arkansas and Idaho. In the other 5 a pharmacist or a pharmacy has to hand it over, and in four of those the law sets an age floor or a screening step. A law that reads as over-the-counter in a headline can still mean a conversation at the counter.

• Arkansas — at the counter: nobody. Nobody. The statute lets it be sold or purchased without a prescription and without consulting anyone.
• Idaho — at the counter: nobody. Nobody. Same wording as Arkansas; a pharmacist may offer counseling but cannot require it.
• Iowa — at the counter: a pharmacy. A pharmacy. It must be distributed by a pharmacist or pharmacy, but the statute sets no protocol, no age floor and no counseling duty.
• Louisiana — at the counter: a pharmacist. A pharmacist, under a prescriber's standing order. Adults 18 and over.
• Missouri — at the counter: a pharmacist. A pharmacist, under board-issued standardized procedures. Kept behind the counter in a secure area.
• Tennessee — at the counter: a pharmacist. A pharmacist, under a collaborative practice agreement. Adults 18 and over.
• Texas — at the counter: a pharmacist. A pharmacist, following written standardized procedures issued by the State Board of Pharmacy.

The seven states where a pharmacy can supply it today

• Tennessee — collaborative agreement, in force since April 22, 2022. Dispensing under a collaborative pharmacy practice agreement with a non-patient-specific prescriptive order. Adults 18 and over.
• Arkansas — over-the-counter sale, in force since March 25, 2025. Statute confers a purchase right: ivermectin may be sold or purchased as an over-the-counter medication without a prescription or consultation.
• Idaho — over-the-counter sale, in force since April 14, 2025. Same purchase-right wording as Arkansas. A pharmacist may offer counseling but cannot require it.
• Louisiana — physician standing order, in force since June 20, 2025. Dispensing under a standing order issued by a prescriber in the Louisiana Department of Health. Adults 18 and over.
• Texas — pharmacist protocol, in force since December 4, 2025. A pharmacist may dispense without a practitioner's prescription order, following written standardized procedures issued by the Texas State Board of Pharmacy.
• Iowa — over-the-counter sale, in force since July 1, 2026. A pharmacist or pharmacy may distribute it as an over-the-counter medicine. No protocol, no age floor and no counseling duty in the enrolled text, but distribution runs through a pharmacy.
• Missouri — pharmacist protocol, in force since August 28, 2026. A pharmacist may dispense without a prescription under written standardized procedures or protocols. Kept behind the counter in a secure area.

Laws that look like access laws and are not

North Dakota — HB 1514 (2021 Special Session) (N.D.C.C. § 43-15-42.4). Creates no dispensing authority. A valid prescription is still required; the section only bars the Board of Pharmacy from disciplining a pharmacist for off-label dispensing. This is a licensing-board protection law only, with parallel sections added for nursing (ch. 43-12.1) and medicine (ch. 43-17), and North Dakota's actual access bill, SB 2388, failed on the Senate floor 3-43 on 4 February 2025.

Where the law is still moving

5 jurisdictions have a live bill and 17 have had one fail. A bill that passed one chamber is not a law.

• Michigan — SB 516 (2025); HB 4837 (2025). Companion bills adding MCL 333.17771 and 333.17771a ("allow over-the-counter access") were introduced on 3 and 4 September 2025 and referred to Government Operations and to Regulatory Reform respectively, with no recorde
• North Carolina — HB 618. HB 618, the Ivermectin Access Act, passed the House on 7 May 2025 and remains in Senate Rules. The 2025-2026 session has not adjourned, so the bill is still live on the record. The host blocks automated retrieval, so thi
• Ohio — SB 249. SB 249 (Sens. Lang and Johnson) would enact R.C. 4729.44 to let a pharmacist or supervised intern dispense ivermectin without a prescription to adults 18 and over under a prescriber-established protocol, but it is still
• Pennsylvania — SB 601. SB 601 (Mastriano), which would amend the Pharmacy Act to provide ivermectin without a prescription or consultation, has had no action since referral to Consumer Protection and Professional Licensure on 21 April 2025, an
• South Carolina — H. 4042. H. 4042 would add S.C. Code Section 44-53-150 allowing over-the-counter purchase of FDA-approved human ivermectin by anyone at least eighteen, kept behind the counter, and it passed the House 100-9 on 5 May 2026 and the

How this table is built

Every row was checked against a primary record: the legislature's own bill history, the enrolled text, the codified statute, or the state board of pharmacy. News coverage and third-party bill trackers were used to find candidates, never to establish a fact. Where a state has no ivermectin statute, the row still cites the search that established the absence, so a reader can repeat it.

38 of 51 rows are marked high confidence, meaning the primary record was retrieved and read. The remainder are marked medium, usually because the legislature's search tool has no full-text option or blocks outside retrieval; those rows say so.

Corrections are welcome and are the fastest way to improve this page. Tell us what is wrong and cite the record.

Take the data

The table is published as a file so it can be checked, quoted and re-used. Attribution is appreciated and a link is enough. If you are writing about this and need something the table does not carry, ask.

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