In which US states is ivermectin available without a prescription as of 2025?

1. Which states — the short, sourced list

Multiple contemporaneous accounts and compilations identify four states where over‑the‑counter access to ivermectin had been authorized by mid‑2025: Idaho, Arkansas, Tennessee and Louisiana ^{[1] [2] [3] [4]}. CNN, reporting on Idaho’s law, described it as making the drug purchasable “just like Tylenol or ibuprofen” after the governor signed legislation ^[3], and other outlets and summaries list Arkansas and Tennessee alongside Idaho and Louisiana as states that had moved to permit OTC sales ^{[1] [4]}.

2. What “available without a prescription” meant in practice

The statutes and press reports do not all describe identical mechanisms: some bills permit pharmacies to dispense human‑form ivermectin without a prescription but keep the product behind the counter and subject to pharmacist oversight, similar to pseudoephedrine controls; others are framed as general OTC availability ^{[1] [5]}. Reporting on Idaho emphasized retail‑style availability after the governor signed a bill into law ^[3], while Arkansas announcements stressed pharmacy discretion and cautions about veterinary products and dosing ^{[6] [7]}.

3. Federal guidance and clinical context

Major health bodies — including the FDA, WHO, EMA and IDSA — did not endorse ivermectin for prevention or treatment of COVID‑19, and reporting on the OTC state moves noted that federal agencies continued to advise against off‑label COVID uses ^[2]. Historical context matters: ivermectin is an approved antiparasitic in humans for specific indications and widely used in veterinary medicine, but evidence that it helps with COVID‑19 was not confirmed and many early positive studies were later discredited or found faulty ^[2].

4. Politics, narratives and the “medical freedom” frame

State legislative action occurred in a charged political environment where advocates describe OTC access as “medical freedom” and lawmakers framed the bills as responding to constituent demand; supporters argued pharmacies and pharmacists could manage safety, while critics warned such laws contradict FDA guidance ^{[6] [8]}. Coverage of Arkansas and Texas debates explicitly ties the push to partisan and advocacy networks that promoted ivermectin during the pandemic ^{[6] [8] [9]}.

5. Ongoing activity and states to watch — limits of available reporting

By mid‑2025 several additional states had proposed or considered similar measures — for example, bills introduced in Florida and Texas drew significant attention later in 2025 — but the sources make clear that passage, implementation details and pharmacy stocking practices can differ and that some reports are press releases or advocacy‑affiliated material that may overstate immediate availability ^{[10] [8] [7]}. The compiled sources explicitly state the four‑state count as of June–July 2025, and later 2025 action in other states is reported separately ^{[1] [2] [11] [5]}.

6. Caveats, practical implications and what wasn’t in the reporting

Reporting suggests practical variability: even where OTC laws passed, pharmacies might keep ivermectin behind the counter, require ID or a pharmacist consultation, or choose not to stock the product — details not uniformly reported across states ^{[1] [5] [6]}. The sources do not provide a comprehensive federal registry of OTC switches nor a state‑by‑state legal text comparison, so the summary above reflects contemporary journalistic and aggregated reporting through mid‑2025 rather than exhaustive legal verification ^{[2] [3]}.

7. Bottom line

Contemporary reporting and public summaries indicate Idaho, Arkansas, Tennessee and Louisiana had laws permitting over‑the‑counter or pharmacist‑dispensed ivermectin without a prescription by mid‑2025, while federal agencies continued to caution against non‑approved uses and other states pursued or debated similar measures ^{[1] [2] [3] [4]}.