Where to Buy Ivermectin in the US: Prescriptions, State Laws, Prices and What to Avoid

Ivermectin tablets are easy to find in the US if you know which route applies to you. Most people get them from an ordinary pharmacy with a prescription. In a handful of states, pharmacists can now dispense them without one. Others order from telehealth services or from international online pharmacies. What you should never do is buy veterinary ivermectin, and it is worth knowing what the tablets actually cost before you pay.

This guide covers each route, what US pharmacies pay for ivermectin according to Medicaid's national price file, how many tablets a normal dose needs, and the safety points from the current Stromectol prescribing information. Every number is attributed to a named source listed at the end.

The short answer

In most of the US, ivermectin tablets need a prescription and are stocked or ordered by any retail or mail-order pharmacy. As of September 2026, at least six states (Arkansas, Idaho, Iowa, Louisiana, Tennessee and Texas) have laws letting pharmacists sell or dispense ivermectin without a prescription, each with its own rules. Ask for generic 3 mg tablets: in September 2026, US pharmacies paid about $2 per generic 3 mg tablet, so a typical 12 mg dose cost them about $8, against about $18 for brand Stromectol or $20 for two generic 6 mg tablets. Never use horse or cattle ivermectin: in one US poison center series, 21 of 37 people treated for ivermectin toxicity were admitted to hospital, and those who took veterinary products took higher doses and had more confusion.

What ivermectin tablets are approved for

Stromectol (ivermectin 3 mg tablets, Merck) is FDA approved for two parasitic worm infections:

• Intestinal strongyloidiasis (Strongyloides stercoralis), usually as a single dose of about 200 mcg per kg. In the studies behind the approval, 64% to 100% of patients were cured by a single dose.
• Onchocerciasis (river blindness), as a single dose of about 150 mcg per kg, repeated at intervals because it does not kill adult worms.

Doctors also prescribe it off-label, most often for scabies. Our ivermectin for scabies dosage guide covers that use. For COVID-19, large randomized trials found no benefit; our Stromectol vs generic ivermectin guide summarises them.

Route 1: a US pharmacy with a prescription

This is the simplest and, for most people, the cheapest route. Any licensed retail, grocery or mail-order pharmacy can fill a prescription for ivermectin tablets. Not every store keeps them on the shelf, but most can order them within a day or two.

• Ask for generic 3 mg tablets. Several FDA-approved generics are rated as therapeutically equivalent to Stromectol, and they cost pharmacies less than half as much (see the price section below).
• Compare cash prices if you do not have insurance or it does not cover ivermectin. Prices vary widely between pharmacies for the same generic, and discount card prices are often lower than the pharmacy's list price.
• Check the quantity. A prescription should state the dose in milligrams and the number of tablets, based on your weight.

A prescription requires a clinician to decide that ivermectin is right for you. For strongyloidiasis, the label also asks for follow-up stool tests to confirm the infection has cleared, which is another reason to have a clinician involved.

Route 2: states where pharmacists can dispense without a prescription

Since 2022, several states have passed laws that let people get ivermectin from a pharmacy without a prescription. Tennessee was first, in 2022. Arkansas, Idaho and Louisiana followed in 2025, Texas's House Bill 25 took effect on 4 December 2025, and Iowa's governor signed House File 2676 in May 2026.

State	How it works (as reported)
Tennessee	Pharmacist dispensing to adults (18 and over) under a collaborative practice agreement, with a screening tool and fact sheet; since 2022
Arkansas	Without a prescription; signed March 2025, in force August 2025
Idaho	Over the counter; signed April 2025
Louisiana	Pharmacist dispensing to adults under a standing order, with screening and counselling, from June 2025
Texas	Behind the counter; pharmacist must discuss side effects before dispensing; from 4 December 2025
Iowa	Pharmacists or pharmacies may distribute it as an over-the-counter medicine (House File 2676, signed May 2026)

Three cautions. The rules differ by state and have been changing, so check your own state's current law and ask the pharmacist. Pharmacies are not obliged to stock ivermectin. And the FDA-approved labelling for ivermectin tablets is still prescription-only: a state law changes who may hand it over in that state, not what the drug is approved to treat or how it should be dosed.

Route 3: telehealth

Many telehealth services can assess you online or by video and send a prescription to a pharmacy of your choice or to their own mail-order pharmacy. This can be useful for scabies or a confirmed worm infection when you cannot easily see your own doctor. A legitimate service will ask about your weight, other medicines (especially warfarin), pregnancy and travel history, and will not prescribe ivermectin for conditions it has not been shown to treat.

Route 4: international online pharmacies

Ivermectin is made by many manufacturers in India and elsewhere, and international online pharmacies, including SafeRxPills, sell it to US customers. These tablets are not FDA-approved products. The FDA says that in most circumstances it is illegal for individuals to import drugs for personal use, and it may refuse a parcel at the border. Our guides to what an international online pharmacy is and to buying from Canadian online pharmacies explain the rules and the checks to make.

If you use this route, choose a seller that names the manufacturer, strength, batch number and expiry date, sells the strengths used in normal dosing (3 mg, 6 mg or 12 mg), and answers questions. Avoid any seller that promotes ivermectin as a cure for COVID-19, cancer or other conditions it has not been shown to treat.

What ivermectin costs: what pharmacies pay

The best public benchmark for US drug prices is the National Average Drug Acquisition Cost (NADAC), based on a monthly survey of what retail pharmacies pay for drugs and updated weekly by the Centers for Medicare and Medicaid Services. It is what the pharmacy pays, not what you pay, but it shows which options are cheap to supply.

Product (NADAC as of 23 September 2026)	Per tablet	Tablets for a 12 mg dose	Cost of a 12 mg dose
Generic ivermectin 3 mg	$1.99	4	$7.98
Stromectol 3 mg (brand)	$4.46	4	$17.84
Generic ivermectin 6 mg	$9.80	2	$19.61

The 6 mg generic is the surprise: per milligram it cost pharmacies more than twice as much as the 3 mg generic. If your pharmacy quotes a high price, ask whether they can dispense the same dose as 3 mg tablets instead.

Ivermectin prices have been falling

The median NADAC for a generic 3 mg tablet stayed close to $3.80 to $3.90 from 2018 to 2022, then fell to $3.42 in 2024, $3.12 in 2025 and $2.24 over January to September 2026, reaching $1.99 in the week of 23 September 2026. The 2026 median is about 40% below 2022's, and the latest week is about 48% below.

Year	Median NADAC per generic 3 mg tablet
2018	$3.87
2019	$3.89
2020	$3.93
2021	$3.82
2022	$3.81
2023	$3.71
2024	$3.42
2025	$3.12
2026 (January to September)	$2.24

The sustained fall began in 2024 and overlaps with a run of new FDA-approved generic versions from late 2024 to 2026, covered in our Stromectol generic guide. More competition usually means lower acquisition costs, although what you pay at the counter also depends on the pharmacy's markup and your insurance.

How many tablets you need

Ivermectin is dosed by body weight. The Stromectol label gives these single doses for strongyloidiasis, using 3 mg tablets:

Body weight	Single dose (strongyloidiasis)	3 mg tablets
15 to 24 kg	3 mg	1
25 to 35 kg	6 mg	2
36 to 50 kg	9 mg	3
51 to 65 kg	12 mg	4
66 to 79 kg	15 mg	5
80 kg or more	200 mcg per kg	By weight

For onchocerciasis the dose is lower, about 150 mcg per kg. For scabies, which is an off-label use, the CDC's guidelines use 200 mcg per kg, repeated after 14 days; see our scabies dosage guide. Safety and effectiveness in children under 15 kg have not been established.

Because 3 mg tablets can be combined to match any weight band, they are the most flexible strength as well as the cheapest per milligram.

Why you do not need 40 mg or 80 mg tablets

Some online sellers, including SafeRxPills, list ivermectin tablets of 40 mg or 80 mg, and some sell veterinary pastes. We do not recommend them for ordinary treatment. At the label dose of 200 mcg per kg, an 80 kg adult needs 16 mg, and a 40 mg tablet would be the dose for a 200 kg person. The label table stops at 15 mg for people under 80 kg. Very high-strength tablets make overdosing easy and cannot be split accurately into normal doses. Buy 3 mg, 6 mg or 12 mg tablets and take the dose your prescriber or pharmacist gives you.

Never use veterinary ivermectin

Ivermectin pastes, pour-ons, drenches and injectables for horses, cattle and sheep are made for animals that weigh hundreds of kilograms. They are far more concentrated than human tablets, may contain inactive ingredients not evaluated for people, and are easy to overdose.

A study of the Oregon Poison Center's cases from August 2021 to January 2022 found 37 people who needed medical care after taking ivermectin to prevent or treat COVID-19. Seventeen had taken veterinary products and fifteen prescription tablets. Twenty-one were admitted to hospital, thirteen were treated in the emergency department, three as outpatients, and one died. Thirty had neurological effects such as confusion. People who took veterinary products took higher doses and more often had altered mental status.

The current Stromectol label also warns of neurotoxicity, including drowsiness, confusion, stupor, coma and death, reported in people without onchocerciasis or Loa loa infection. These reactions generally resolved with supportive care and stopping ivermectin. Our ivermectin side effects guide covers the full label.

Ivermectin and COVID-19: why pharmacies became cautious

During the pandemic, US retail pharmacies went from dispensing an average of 3,589 ivermectin prescriptions a week before the pandemic to 39,102 in the week ending 8 January 2021, an increase of 989%, according to a CDC analysis of national pharmacy data. A CDC health alert later reported more than 88,000 in the week ending 13 August 2021, a 24-fold increase. Randomized trials later found no benefit for COVID-19. That history is why a pharmacist may ask what a prescription is for. For the approved uses, a valid prescription is enough.

How to spot an unsafe ivermectin seller

• It promotes ivermectin for COVID-19, cancer, "detox" or other uses without evidence.
• It sells veterinary pastes or drenches in a way that suggests people can take them.
• It pushes very high-strength tablets or multi-month supplies for a single-dose treatment.
• It does not name the manufacturer, or the tablets arrive loose, unlabelled, or without batch number and expiry date.
• It has no pharmacist or clinician you can contact, and no physical address.

How to take it correctly

• For the approved worm infections, take the tablets on an empty stomach with water, as the label directs. A high-fat meal raised the amount absorbed about 2.5-fold in a pharmacokinetic study.
• For scabies, the CDC's treatment guidelines advise taking ivermectin with food, because better absorption helps the drug reach the skin, and a second dose after 14 days is standard.
• Take the whole dose at once unless you have been told otherwise. For strongyloidiasis, one dose is usually enough, followed by stool tests.
• Do not repeat doses on your own. Repeating is part of standard scabies regimens and of onchocerciasis treatment, but the timing should come from your prescriber.

Who should check with a doctor first

• Pregnancy: the label says ivermectin should not be used in pregnancy because safety has not been established.
• Breastfeeding: ivermectin passes into breast milk in low amounts; the label advises treating only when delay is riskier.
• Warfarin: the label notes rare reports of a raised INR when the two are taken together.
• Children under 15 kg: safety and effectiveness have not been established.
• Time spent in west or central Africa: people with heavy Loa loa infection can develop a serious brain reaction after treatment, so tell your clinician if you have lived in or travelled to areas where it occurs.
• A weakened immune system: strongyloidiasis may need repeated courses.

Outside the US

Ivermectin tablets are prescription medicines in the UK, Canada and Australia, and rules on ordering them from abroad differ. Australian readers can see our guide to buying ivermectin in Australia.

Where SafeRxPills fits

SafeRxPills sells ivermectin tablets made by manufacturers in India, including Ivercor 3 mg, Ivercor 6 mg and Ivercor 12 mg. They are not FDA-approved products, and the FDA's personal importation rules apply to them. If you have insurance or live in a state with pharmacist dispensing, a US pharmacy is likely to be simpler and, with generic 3 mg tablets now costing pharmacies about $2 each, may well be cheaper. Our ivermectin in the USA page explains delivery and ordering if you choose us.

A checklist before you buy

1. Is ivermectin right for your condition? Get a diagnosis for worms or scabies first.
2. Do you know your dose in milligrams, based on your weight?
3. Have you checked a US pharmacy's cash or insurance price for generic 3 mg tablets?
4. If your state allows pharmacist dispensing, has the pharmacist checked your other medicines?
5. If you are buying online, does the seller name the manufacturer, batch and expiry, and sell normal strengths?
6. Are you avoiding veterinary products and very high-strength tablets?

Choosing between two Indian 12 mg brands? Our Ivecop 12 vs Ivercor 12 comparison covers makers, prices and which weight a 12 mg tablet fits.

Sources

• STROMECTOL (ivermectin) tablets, US prescribing information (Merck), Clinical Pharmacology, Indications, Warnings, Precautions and Dosage and Administration. DailyMed
• Centers for Medicare and Medicaid Services. National Average Drug Acquisition Cost (NADAC) files, 2018 to 2026, as of 23 September 2026. data.medicaid.gov
• Hoang R et al. Characteristics of ivermectin toxicity in patients taking veterinary and human formulations for the prevention and treatment of COVID-19. Clin Toxicol (Phila) 2022;60(12):1350-5. PMID 36374218.
• Lind JN et al. Increase in outpatient ivermectin dispensing in the US during the COVID-19 pandemic: a cross-sectional analysis. J Gen Intern Med 2021;36(9):2909-11. PMID 34145521.
• Pharmacy Times. Four states pass laws allowing OTC ivermectin, more states pending legislation, 11 July 2025. Pharmacy Times
• Tennessee Code Annotated 63-10-224; Iowa House File 2676 (2026). Iowa Legislature
• US Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021: ectoparasitic infections (scabies); Health Alert Network advisory HAN 00449, 26 August 2021.
• The Texas Tribune. Texas ivermectin law (House Bill 25), 27 August 2025. Texas Tribune
• US Food and Drug Administration. Personal Importation. FDA

This article is for information only and is not medical or legal advice. Ivermectin is a prescription medicine under its FDA labelling. Talk to a doctor or pharmacist before taking it, and check your state's current rules.