How many states is ivermectin over the counter
This fact-check may be outdated. Consider refreshing it to get the most current information.
Executive summary
As of December 2025, reporting shows at least five U.S. states have moved to allow over‑the‑counter (OTC) sales of ivermectin — Arkansas, Idaho, Tennessee and two more including Texas, which became the fifth when its law took effect Dec. 4, 2025 [1] [2] [3]. National coverage in April and mid‑2025 noted three states had already legalized OTC sales earlier in the year and others passed or proposed similar measures, producing a patchwork of state laws rather than a federal rule change [4] [1].
1. Who’s changed the rules — state by state, not the FDA
States have used their legislatures to authorize pharmacists or retailers to sell ivermectin without a prescription; Idaho’s 2025 law explicitly permits ivermectin “suitable for human use” to be sold OTC and Idaho health agencies issued guidance to pharmacists about handling it [5]. Arkansas and Tennessee passed similar measures earlier in 2025, and Texas’ HB25 — signed by the governor and effective Dec. 4, 2025 — made Texas the fifth state to approve OTC sales [1] [3] [2]. CNN and other outlets characterized this as state action, noting OTC status in these states is the product of state law rather than an FDA reclassification [4] [6].
2. How many states? The reporting: “three,” “four,” “five,” and more proposed
Different outlets reported different counts at various points in 2025: CNN and CNN‑syndicated pieces in April cited three states that had legalized OTC ivermectin [4] [6]. Pharmacy Times reported four states had passed laws by July 10, 2025, and later coverage marked Texas as the fifth in August/December [1] [3]. Other trackers and local outlets list more states proposing bills or moving in that direction; one site claimed 11 or more but is not mainstream and lacks corroboration in our provided files [7] [8]. Available sources do not provide a single, definitive nationwide tally beyond those specific state examples cited above.
3. Why states acted: access, politics and “medical freedom” arguments
Proponents frame OTC availability as improving access in rural areas, reducing reliance on animal‑formulations, and protecting personal choice; Texas lawmakers explicitly argued the change supports access and medical freedom [9] [10]. Pharmacy and public‑health commentators warn legislators are making an unusual move by sidestepping the FDA’s traditional federal role in OTC determinations [4]. Several sources say backers emphasize access while critics point to political and ideological drivers behind the push [10] [11].
4. Public‑health concerns and regulatory friction
Health experts and the FDA have repeatedly warned animal formulations differ from human‑approved ivermectin and can be dangerous; Pharmacy Times and other reporting quoted the FDA warning against using animal products in people [1]. CNN and local reporting highlight that the drug is FDA‑approved for certain parasitic infections but not for COVID‑19, and public‑health authorities fear OTC status could increase misuse, dosing errors and self‑medication for unproven indications [4] [6].
5. What the patchwork means in practice for consumers and pharmacists
Even where laws permit OTC sales, pharmacy chains or pharmacists may still choose not to stock or sell ivermectin OTC; Arizona reporting noted uncertainty whether major chains would carry it and suggested small independents might [11]. Idaho issued guidance to pharmacists on how to handle OTC sales, indicating states are trying to manage practical and liability questions even as laws change [5].
6. Limits of the available reporting and what’s not in these sources
Provided sources name specific states (Arkansas, Idaho, Tennessee, Texas) and report a gradual increase in adopters and proposals [1] [3] [4]. They also show disagreement in counts over time — three, four, five — and list multiple pending bills [1] [8]. Available sources do not supply a definitive, current nationwide count listing every state that permits OTC ivermectin as of this moment; they do not report a federal FDA reclassification of ivermectin to OTC status [4] [1].
Bottom line: the trend is real and accelerating — several states have enacted laws allowing OTC ivermectin and others have proposed bills — but the change is a state‑by‑state mosaic with public‑health experts and regulators warning about safety, and no evidence in these sources of an FDA‑led, nationwide OTC conversion [1] [4] [3].