Idaho Allows Over-the-Counter Ivermectin Sales

Idaho Legalizes Over-the-Counter Ivermectin Amidst Safety Concerns

April 26, 2025

BOISE, Idaho – In a move that has sparked considerable debate, Idaho Gov. Brad Little signed Senate bill 1211 into law, effectively allowing the sale of ivermectin without a prescription. The bill, which went into affect instantly due to an emergency clause, permits individuals to purchase the drug over-the-counter, bypassing the need for consultation with a healthcare professional.This decision places Idaho alongside Arkansas and Tennessee as states adopting this approach, while North Carolina considers similar legislation.

Ivermectin, typically used to treat parasitic infections, gained notoriety during the COVID-19 pandemic. Proponents, frequently enough including conservative activists and politicians, promoted it as an alternative treatment for the virus, despite a lack of scientific consensus supporting its efficacy.

FDA’s Stance and Safety Warnings

The U.S.Food and Drug Administration (FDA) maintains that there is insufficient evidence to support the use of ivermectin for treating or preventing COVID-19. The agency’s website explicitly states that existing clinical trial data does not demonstrate its effectiveness against the virus in humans. Furthermore, the FDA warns of potential dangers associated with ivermectin use, including the risk of severe adverse effects from large doses and potential interactions with other medications, such as blood thinners like Warfarin (Coumadin) commonly prescribed in the U.S. for patients with atrial fibrillation or a history of blood clots.

“Ivermectin is not authorized or approved by FDA for use in treating or preventing COVID-19.”

U.S. Food and Drug administration

This stance aligns with that of the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), which also do not recommend ivermectin for COVID-19 treatment.

Legislative Process and Stakeholder Concerns

The passage of Senate Bill 1211 occurred swiftly during the final week of the legislative session. Notably, Idaho lawmakers did not solicit public feedback from doctors, pharmacists, or other healthcare professionals before passing the bill.Key sponsors of the bill included prominent Republican figures such as Senate President Pro Tempore Kelly Anthon, R-Rupert, and House Speaker Mike Moyle, R-Star, along with Sens.tammy Nichols, R-Middleton and Rep. Jordan Redman, R-Coeur d’Alene.

Pam Eaton, CEO of the Idaho Retailers Association, which represents Idaho pharmacies, raised concerns about the practical implications of the law. Eaton testified in a Senate committee that, without an over-the-counter label providing essential information like potential drug interactions, pharmacies would face challenges in selling ivermectin over-the-counter.

Without an over-the-counter label that includes information like drug interactions, Idaho pharmacies largely can’t sell ivermectin over-the-counter.

Pam Eaton, CEO of the Idaho Retailers Association

This lack of clear labeling guidelines could lead to confusion among consumers and perhaps increase the risk of misuse or adverse reactions. An example of a common drug interaction concern in the US is the use of ivermectin with blood thinners such as Warfarin where it can significantly alter the INR levels which are used to guide dosing and monitor safety of Warfarin.

Public Health Implications and Expert Opinions

The decision to deregulate ivermectin in Idaho has drawn criticism from medical experts and public health officials. Dr. David Pate, former CEO of St. Luke’s Health System in Idaho, has been a vocal critic of the bill, arguing that it undermines the role of healthcare professionals and could lead to inappropriate use of the drug. He and others emphasize that relying on unproven treatments like ivermectin could divert individuals from seeking evidence-based medical care, potentially worsening thier conditions.

Dr.Pate told the Idaho Capital Sun, “This is a dangerous policy that puts Idahoans at risk.”

In the U.S., the rise in popularity of unproven treatments, especially during the COVID-19 pandemic, has been a concern for public health officials. This trend has been fueled by misinformation and distrust in established medical institutions, highlighting the need for improved public health communication and education.

Comparative Analysis: Ivermectin Regulations in Other States

While Idaho, arkansas, and Tennessee have loosened restrictions on ivermectin, most states continue to require a prescription for its use. The differing approaches reflect varying perspectives on the balance between individual autonomy and public health concerns. The American Medical Association (AMA) and the American Pharmacists Association (APhA) have both issued statements opposing the widespread use of ivermectin for COVID-19, citing a lack of evidence of efficacy and potential safety risks.

State	Ivermectin Regulation	Rationale
Idaho	Over-the-counter	Legislative decision emphasizing individual access.
Arkansas	Over-the-counter	Similar to Idaho,emphasizing access.
Tennessee	over-the-counter	Early adoption of over-the-counter availability.
Most Other States	Prescription Required	Concerns over safety and lack of proven efficacy for off-label uses.

Recent Developments and Practical Applications

Since the passage of the bill, Idaho pharmacies have been grappling with the practicalities of selling ivermectin over-the-counter. Some pharmacies have expressed reluctance to stock the drug due to liability concerns and the lack of clear labeling guidelines. Others are waiting for further guidance from the Idaho Board of Pharmacy regarding best practices for dispensing the medication.

One emerging concern is the potential for increased demand for ivermectin, leading to shortages for its approved uses in treating parasitic infections. This could disproportionately affect vulnerable populations who rely on the drug for legitimate medical purposes.

In the U.S., the debate over ivermectin highlights broader issues related to evidence-based medicine, regulatory oversight, and the role of personal beliefs in healthcare decisions. The case of Idaho serves as a reminder of the ongoing challenges in balancing individual freedoms with the duty to protect public health.