Tag: ivermectin bill in Iowa legislature

Iowa Bill HF2676 Which Would Allow OTC Ivermectin in Iowa On its Way to Governor Reynolds Desk

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.

What’s Up with the Ivermectin Bill in Iowa?

I’m trying to find out what’s happening with Governor Reynolds’ MAHA bill (HF 2676) which includes allowing Iowa pharmacists to provide ivermectin without a prescription to those who prefer taking it, most likely for something else other than what’s indicated for, which is treating parasitic infections. The risk is that persons will try to use it to self-treat other diseases such as Covid 19 infections, for which there is no convincing evidence supporting ivermectin’s effectiveness.

There’s a list of bills signed into law by the governor as of April 16, 2026 which doesn’t include HF 2676. My understanding is that this year’s legislative session would be ending maybe as soon as tomorrow.

I found one source on the web which indicates the Iowa House passed it. It then went to the Senate, which passed the bill with the ivermectin part intact and it was returned to the House. It’s not clear whether Governor Reynolds actually needs to sign it into law.

My usual go-to news source for Iowa lawmaker news is the Iowa Capital Dispatch, but it doesn’t seem to have any recent updates on this bill.

The language of the bill regarding so-called over-the-counter ivermectin is permissive, meaning pharmacists may (not must) provide ivermectin, not making it mandatory for Iowa pharmacists to hand over ivermectin to anyone who requests it. And pharmacists would be exempt from “…professional discipline or civil or criminal penalties for distributing ivermectin…”

It doesn’t look like anyone considered what recourse patients might have if they suffer injury as a result of taking ivermectin for a non-FDA approved (off label) condition.

Ivermectin Bill Looks Like It’s Dead-For Now

This is a quick followup on the progress of Governor Reynolds MAHA bill which included a piece endorsing making Ivermectin available over-the-counter in Iowa. I just read a story about what looks like the disappearance of the ivermectin from Reynold’s bill. The story, written by Laura Belin, comes from a webpage called Bleeding Heartland: An independent website about Iowa politics.

I don’t follow politics avidly (putting it mildly), but I think I understand a short paragraph from Ms. Belin’s article”:

“The Senate didn’t advance the governor’s bill. Instead, Senate Health and Human Services Committee chair Kara Warme introduced her own “health-related matters” bill, which got through committee and is eligible for floor debate. That legislation (Senate File 2367) incorporated the governor’s proposals on nutrition education, certificates of need for health care facilities, federal food assistance, and food dyes in schools, but left the ivermectin language on the cutting room floor.”

It looks like another anti-vaccine bill bit the dust—for now. I would cheer, but I know better. I expect somebody will resurrect it at some time in the future. I hope Dr. Austin Baeth is still around when it happens.

Iowa Ivermectin Bill Heads to the Senate

I see the Iowa House passed HF 2676 including the ivermectin section which would make the anti-parasite drug available over-the-counter (OTC) in Iowa, despite arguments against it about the medical indications for the drug, which don’t include treatment of cancer and Covid-19 infection. There’s a high probability that some people might use it to treat those conditions. It now goes to the Senate.

It’s worth pointing out that a stand-alone version of this bill died in the first funnel. The text of this alternative bill, which is sponsored by Governor Reynolds, is distinctly different from the first one. It uses permissive language saying a pharmacist “may” (instead of “shall”) make this prescription drug used to treat parasite infections in humans and animals available OTC to those who want it for what some might call off-label use.

Recall the original version of this bill said the “medical director” of a pharmacy should write a “standing order” for ivermectin to be available “OTC.” This probably blurs what’s actually implied, which is that someone with “prescriptive authority” write the standing order, such as a physician.

This is clarified in the laws recently passed in June of 2025 in the Louisiana legislature stating that “pharmacists can dispense ivermectin to adults pursuant to a standing order issued by a health care professional with prescriptive authority. When administering ivermectin to a patient, the rule requires pharmacists to provide information on indications and contraindications. A screening risk assessment tool is also required. Pharmacists may charge an administrative fee for these services.”

It looks like Iowa might be taking a slightly different approach. By the state making ivermectin OTC in the first place, the “standing order” piece is bypassed to avoid the apparent contradiction of ivermectin (a prescription drug) having both OTC and prescription features.

But it gets more complicated than that because Iowa has authorized a collaborative drug therapy management arrangement by which a licensed prescriber may allow an authorized pharmacist to prescribe certain drugs. Further, even though states can’t override FDA classification of a drug, they can decide on whether a drug needs a prescription or not. Would it make sense to ask what reason would there be for legislators to seek non-prescription status for a drug—other than expedience?

Under this bill, a pharmacist can’t be sued or be held criminally liable if patients suffer injury or even death by taking ivermectin for an indication which doesn’t make sense to medical science. By contrast, if someone suffers an adverse effect from a vaccine, patients and families have access to the Vaccine Injury Compensation Program and if that’s not effective, they can file lawsuits in state and federal courts. If this sounds unfair, there’s a reason for that which people might not discover until it’s too late. A strong mitigating factor is the pharmacist’s ethical standards.

The FDA has provided guidance about unapproved (off-label) use of FDA-approved drugs. It’s possible to use an approved drug for an unapproved use. However, the major reason why a physician might consider doing this is usually because an approved drug is not available to treat a patient’s condition.

In this case, ivermectin is approved for treatment of parasitic infections and there’s no credible scientific evidence it’s effective for treatment of Covid-19 or certain types of cancers. Off label use is not illegal in the U.S. Insurance may or may not cover the cost. There are a number of drugs used off-label, including the popular drug Ozempic, approved for diabetes and used off-label for weight loss.

I hope the Senate considers the potential for medical trouble with HF 2676.

Iowa Legislature Ivermectin Bill A Game of “Captain, May I?”

I’ve been comparing the Iowa legislature bills on allowing ivermectin to be available over-the-counter in pharmacies. There were two of them and then there was one.

In the first bill, HF 2056, the language in it seemed to strongly direct pharmacists to make ivermectin available by using the word “shall”:

  1. ” The medical director of the department shall establish a standing order authorizing the dispensing of hydroxychloroquine and ivermectin by a pharmacist.

Notwithstanding any provision of law to the contrary, a pharmacist shall dispense hydroxychloroquine or ivermectin to a patient who is at least eighteen years of age, upon the request of a patient, pursuant to a standing order established by the medical director of the department in accordance with this section.”

The bill goes to say that “A pharmacist shall be immune from criminal and civil liability arising from any damages caused by the dispensing or use of…” these agents.

In Governor Reynolds version of the bill (included in HF 2676, successor to HSB 964), at least today, uses the word “may”:

“Sec. 17. NEW SECTION. 126.24 Ivermectin—prescription drug order not required.

  1. A pharmacist or pharmacy may distribute ivermectin for human consumption as an over-the-counter medicine.
  2. A pharmacist or pharmacy shall not be subject to professional discipline or civil or criminal penalties for the distribution of ivermectin pursuant to this section.”

I think the word “may” in Governor Reynolds’s bill implies a pharmacist can distribute ivermectin, but is not necessarily required to do so. In the HF 2056 bill (which died in the first funnel) the word “shall” implies the pharmacist must do so. Hydroxychloroquine is not mentioned in the governor’s version of the bill.

Although neither of these bills mentioned why the ivermectin bill is being introduced, I think it’s clear that some people think it could be an alternative to vaccines for Covid-19. Because research shows ivermectin is ineffective for treating Covid-19 and because they’re not FDA approved for that, I doubt any pharmacist would choose to do what the bill says.

This seems to be turning into a weird game of “Captain, May I?” I think the majority of pharmacists would rather not play.