Iowa lawmakers advance bill allowing over-the-counter ivermectin, hydroxychloroquine

DES MOINES — Iowans would be able to purchase ivermectin and hydroxychloroquine without a prescription under legislation advanced in the Iowa Legislature Thursday, a move that medical professionals say could harm Iowans.

Ivermectin, an antiparasitic drug most popularly used to treat worm infections like lice and intestinal worms in humans and animals, grew in popularity in 2020 when some people used it to treat COVID-19. Since then, a slate of other states, including Arkansas, Idaho, Louisiana, Tennessee and Texas, have allowed it to be sold over-the-counter, arguing it enhances medical freedom.

The U.S. Food and Drug Administration has not authorized or approved ivermectin for use in preventing or treating COVID-19 in humans or animals. It also has been determined that the drug is not effective in treating COVID-19.

Iowa House lawmakers advanced House File 2056 out of a House health and human services subcommittee on Thursday. The bill would require pharmacists to dispense ivermectin and hydroxychloroquine, which is commonly used to treat malaria, without a prescription to individuals 18 years or older.

The legislation would prohibit prescribers from requiring appointments with pharmacists before the drugs are dispensed.

Republican state Rep. Eddie Andrews, of Johnston, who also is running for Iowa governor, argued the legislation would give Iowans the freedom to use the medication how they see fit, adding that other drugs, including Tylenol and Mucinex, once required prescriptions.

“There are plenty of over-the-counter medicines that do have side effects,” Andrews said. “I think we'd be living in a fantasy world to understand that the opposite of what was just talked about was not true during the COVID period, where pharmacists were told not and doctors were told not to prescribe certain pills.”

Over-the-counter ivermectin is being spotlighted this session as Gov. Kim Reynolds made it one of her legislative priorities for 2026.

But multiple medical professionals and medical advocacy groups warned that dispensing the drugs to individuals without a prescription could lead to adverse effects, noting that both come with multiple side effects that other over-the-counter medications do not cause.

Democratic Rep. Austin Baeth, of Des Moines, who is a physician, said the legislation is “reckless” and would mandate malpractice by requiring physicians to prescribe medications regardless of whether they believe it will harm their patients.

“This is one of the most reckless, dangerous bills I have seen. I'm shocked that it even got a subcommittee. This needs to go in the trash immediately,” Baeth said.

“To make over-the-counter an experimental drug for people just to experiment on themselves, completely undermines the reason why we have a drug prescription process in the first place. What's next? If we have, you know, a small group of people who next believe that blood thinners cure this, and then will we have blood thinners over-the-counter, where we have fentanyl over-the-counter? Where do we stop this?” he continued.

Baeth also noted a provision in the bill would not allow pharmacists to keep a record of who they dispense ivermectin and hydroxychloroquine to, which he said would make it difficult to understand the broader impacts in the future.

Republican Rep. Brett Barker, of Nevada, who is a pharmacist, said he has “strong concerns” about the bill as written. He raised concerns about the precedent of mandating pharmacists and health care providers to dispense specific drugs, saying it could in the future include abortion pills.

“Pharmacists have a corresponding responsibility to ensure the safety and appropriateness of every prescription that they provide to a patient,” Barker said. “That's the core of the professional autonomy of the profession. And so then there's no other place in Iowa code that we force health care providers to do something like that and to provide a specific treatment.”

Despite his concerns, Barker joined Andrews in signing on to advance the legislation, adding that he will have further conversations with the committee. Baeth declined to sign on to advance the bill to the full committee.

Health care professionals raise concerns

Wes Pilkington, an Evansdale pharmacy owner and president of the Iowa Pharmacy Association, said the patients he dispenses the drugs to are closely monitored by health care providers every few months to ensure safety, especially hydroxychloroquine.

“Pharmacists are not vending machines. We're licensed health care professionals whose role is to ensure medications are safe and appropriate before they reach the patient,” Pilkington said.

“What prevents a patient from following high-dose recommendations found online and obtaining repeated prescriptions? What stops them from visiting multiple pharmacies or obtaining a new prescription every week or every month? What happens when an elderly patient with known cardiac or kidney disease presents for one of these medications?” he continued.

Pilkington said ivermectin can cause severe skin reactions, drops in blood pressure, depression, neurotoxicity, impaired consciousness and liver inflammation.

Hydroxychloroquine can cause fatal cardiac arrhythmias, severe hypoglycemia, blood disorders, irreversible retinal damage, lung disease, acute liver failure and kidney injury, according to the Mayo Clinic.

Proponents say bill would increase access to ivermectin

Lindsay Maher, leader of the medical freedom advocacy group Informed Choice Iowa, said that research is ongoing around using ivermectin to help treat autoimmune diseases and cancer, and allowing it to be dispensed over-the-counter could help those across the state, including in rural areas, access it. She also noted that it is already offered over-the-counter in five other states.

“We've unfortunately seen regulators step in and say, especially during the pandemic, whether or not doctors could prescribe this, including the state of Iowa,” Maher said. “With all drugs and biologics, there are never a one-size-fits-all.”