Ivermectin to be OTC in Arkansas

Arkansas Governor Sarah Huckabee Sanders signed SB189 last Tuesday, March 25, allowing the sale and purchase of ivermectin for human use without a prescription. The law will take effect 90 days after the Arkansas State Legislature adjourns.

The legislation states explicitly that “ivermectin suitable for human use may be sold or purchased as an over-the-counter medication in this state without a prescription or consultation with a healthcare professional.” This marks a major policy shift, as the drug has traditionally required a doctor’s prescription.  

Supporters of the legislation argued that expanding access would allow individuals to make their own healthcare decisions. Critics, however, warned that removing professional oversight could lead to misuse and potential health risks. 

Ivermectin is widely used to treat parasitic infections in both humans and animals. However, it became a focal point of controversy during the COVID-19 pandemic, when some individuals promoted it as a treatment for the virus despite warnings from health authorities. The U.S. Food and Drug Administration (FDA) has cautioned against using ivermectin for COVID-19, stating that it is not an approved treatment for the virus.  

Early in the Covid pandemic, ivermectin was one of several treatments proposed to mitigate the severity of COVID infections. However, its use was strongly discouraged by the FDA, Centers for Disease Control (CDC) and the National Institute of Allergy and Infectious Diseases (NIH).

A meta-analysis released March 20, 2025 of 64 higher-quality studies by 58 independent teams in 27 different countries show significant improvements in both morbidity and mortality from COVID using ivermectin treatment. The meta-analysis reports “significantly lower risk is seen for mortality, ventilation, ICU admission, hospitalization, recovery, cases, and viral clearance.” Using the most serious outcomes, this study showed an overall 61% lower risk for early treatment and an overall 85% lower risk for prophylaxis.

The authors point out that their results are “very robust,” even with only considering 63 of the 105 studies initially screened. The other 42 studies were excluded to avoid finding a (false) statistically significant efficacy.

While the authors caution that “no treatment is 100% effective,” they describe their results as “robust,” especially with early treatment and prophylaxis.

This is not the first meta-analysis to show a positive benefit from ivermectin, but it is one of the largest to date.

In Alabama, State Representative Phillip Rigsby (R-25) has introduced HB278, which would allow practitioners to give pharmacists a standing order to dispense ivermectin without a prescription. It is currently before the House Health Committee.