Late yesterday, there was a story published in the Iowa Capital Dispatch announcing that the MAHA bill HF2676 is on its way to Governor Reynolds for her signature. A part of that bill “…also would allow ivermectin, a drug used to treat parasitic infections that some have claimed can be used in preventing or treating symptoms of COVID-19, to be distributed over the counter by pharmacies.”
She will probably sign it, making Iowa one of a handful of states in the U.S. which allows human-grade ivermectin available over-the-counter in pharmacies. I think saying it would be OTC is partly a misnomer because it would actually be more like “behind the counter” as it’s not packaged to be sold that way, for example, in places like Walgreens.
The language of the bill is permissive, though, which means that pharmacists “may” (not “shall”) make ivermectin available OTC. I’m surprised that she’s quoted in the story saying the bill “takes common sense steps to improve health and well-being for Iowans of all ages.” Nothing further from the truth could be said regarding the ivermectin piece. There’s no good evidence that it’s effective for treating Covid-19 infection.
That said, I’m not sure how this bill once it’s signed into law would be enforceable. Pharmacists and/or other health professionals are not required to unilaterally or collaboratively set up a standing order making ivermectin available OTC. I think you’d still need to have a prescription if you need it to treat parasite infections.
If you drive up to the window and request human-grade ivermectin, the law would not prevent a pharmacist from asking you why you want it. I’m aware of off-label indications for medications. The American College of Medical Toxicology (ACMT) published a paper in 2022 cautioning against off-label prescribing of ivermectin for treatment of Covid-19. I agree with their statement that “clinicians, not courts should direct medical care.” By extension, I think that you could substitute the word “legislatures” for “courts.”
Calello DP, Kazzi Z, Stolbach A. American College of Medical Toxicology (ACMT) Cautions Against Off-Label Prescribing of Ivermectin for the Prevention or Treatment of COVID-19. J Med Toxicol. 2022 Jan;18(1):69-70. doi: 10.1007/s13181-021-00866-z. Epub 2022 Jan 10. PMID: 35006547; PMCID: PMC8744041.
I realize there’s a lot of off-label prescribing of drugs going on out there. Ozempic is one of them. I have not read the news article warning about “Ozempic penis.” I have read the FDA’s announcement about off label use of ivermectin.
The push for ivermectin off-label use for Covid-19 looks politically motivated, in my opinion. Governor Reynolds will likely sign into law HF 2676 including the small part about ivermectin which really doesn’t seem to belong in the bill. It’ll be a pyrrhic victory. I think it makes the legislators who supported it and the governor look bad. Further, I think it makes Iowa look bad. I doubt Iowa pharmacists, one of whom refused to fill a prescription for ivermectin for Covid-19 a few years ago, will have any trouble declining to provide ivermectin to anyone who wants to use it to treat Covid-19.
OK, on the lighter side I’m going to pour a little cold water on ivermectin regarding its use as an antiparasitic agent. Does it work for ticks? The reason I bring this up is that last week, my wife Sena did not use OFF! Deep Woods insect repellent before going out into the backyard garden which borders on a woodsy outlot. When she came inside, she asked me to take a look at the back of her neck because she felt something crawling on her. I plucked a tick from her hair and flushed it down the sink.
Then, this morning I noticed a CDC article published last week about visits to emergency rooms for tick bites being higher than usual. Ticks can make you really sick. They cause several diseases including something I didn’t know much about which is alpha-gal syndrome. That’s not a term invented to compete with the alpha male syndrome. The “gal” is short for galactose and if a tick infects you with it, you can get allergic to red meat (tick bite meat allergy). Then you’d have to avoid eating red meat.
So, is ivermectin effective against ticks? There was a study published 12 years ago that said it was not. On the other hand, there’s a story that says ivermectin is protective against ticks—in deer, not in humans. Don’t forget the OFF!
Sheele JM, Ford LR, Tse A, Chidester B, Byers PA, Sonenshine DE. The use of ivermectin to kill ixodes scapularis ticks feeding on humans. Wilderness Environ Med. 2014 Mar;25(1):29-34. doi: 10.1016/j.wem.2013.09.008. Epub 2014 Jan 9. PMID: 24411976.
Go Retire Psychiatrist 