Which States Allow Over-the-Counter Ivermectin? (2026 Guide)
The mechanics differ from state to state, and the difference matters when you are standing at a pharmacy counter. Here is the current map, what each law actually says, and what to do if your state is not on the list.
States where ivermectin is available without bringing a prescription
| State | Since | Law | How it works |
|---|---|---|---|
| Tennessee First in the nation | 2022 | Tenn. Code § 63-10-224 | Pharmacist dispensing under a collaborative pharmacy practice agreement (a standing-order style model). You do not bring a prescription; the pharmacy handles authorization through its agreement with a prescriber. |
| Arkansas OTC statute | March 2025 | SB 189 / Act 369 | Reclassifies human-use ivermectin so it may be sold over the counter without a prescription or consultation. |
| Idaho OTC statute | April 2025 | SB 1211 | Allows over-the-counter sale of human-use ivermectin without a prescription. |
| Louisiana OTC statute | June 2025 | SB 19 / Act 464 | Permits over-the-counter purchase of human-use ivermectin without a prescription. |
| Texas OTC statute | December 2025 | 2025 legislation | Makes ivermectin available without a doctor’s prescription at the pharmacy. |
One practical note: a state allowing OTC sale does not mean every pharmacy shelf stocks it. Availability depends on the individual pharmacy, and quality varies. A compounding pharmacy that works from USP-grade raw material with a Certificate of Analysis on every batch is a different product than whatever happens to be on a shelf.
States with legislation pending in 2026
Bills to allow over-the-counter ivermectin have been introduced or advanced in several states this year, including Florida (HB 29), Mississippi, Iowa, and West Virginia. Laws in this area are moving quickly; if your state is on this list, the status may have changed since this guide was updated.
Tennessee: the original, and still the most complete model
Tennessee started all of this in 2022, and its standing-order style model remains unique: instead of simply putting ivermectin on a shelf, the law routes access through pharmacists working under collaborative practice agreements, so a licensed professional stays involved in every dispensing decision.
We are a licensed compounding pharmacy in Hixson (Chattanooga), Tennessee operating under exactly this framework. Full details, process, and FAQs are on our Ivermectin in Tennessee page, and our guide to compounded ivermectin for human use covers what pharmacy-grade quality means.
What if your state is not on the list?
Ivermectin is still accessible in most other states through the standard legal route: a licensed provider reviews your health information online and, where appropriate, issues the prescription, which is then filled by a licensed pharmacy and shipped to you. That is exactly how our process works. You complete a short health form, a licensed provider reviews it, the prescription is included with your order, and your capsules are compounded from USP-grade ivermectin and shipped in discreet packaging.