Texans could soon get ivermectin without a prescription

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Ivermectin, the livestock anti-parasitic drug that became a popular yet unproven COVID-19 treatment, could be available in Texas without a prescription if a bill passes this special legislative session.

House Bill 25, filed by state Rep. Joanne Shofner, R-Nacogdoches, would not put the drug out on pharmacy shelves. But if her bill passes both legislative chambers, ivermectin would be available upon request from behind the pharmacist’s counter as Texans already do for other drugs, like Sudafed.

“If it didn’t work, no one would be interested in it,” Shofner said Tuesday. “The results speak for themselves and everyone has a story about how they took ivermectin and they felt 90% better the next day.”

She insists that making ivermectin available without the added step of getting a doctor to prescribe it is a critical issue for her district and many in the state who want to take it. As she told the House Public Health Committee last week, “I'm in a rural community here. People have to drive an hour and a half to get to the doctor and Walgreens is a block away.”

Shofner filed an identical bill during the regular session but the House didn’t vote on it, despite 58 pages of online testimony filed by residents who want to be able to access it without a prescription. This time around, her bill comes with the support of Gov. Greg Abbott who put ivermectin access on his expanded priority list last week after Texans for Vaccine Choice sent 7,000 signatures in support of the drug.

“Like penicillin and aspirin, ivermectin is a safe, affordable medicine with minimal side effects,” Shofner said.

Ivermectin has remained relevant since the COVID-era zeitgeist that fueled skepticism of mainstream medicine and the health care system at-large. Medical freedom advocates want to remove barriers that prevent them from taking whatever medication they say will make them healthier — especially if it’s an alternative to vaccines — even if its effectiveness is debatable. And, ivermectin is a model for their beliefs.

While it has approved the use of ivermectin in humans to treat parasitic worms, the federal Food and Drug Administration has not approved its use in preventing or treating COVID-19.

Through social media during the pandemic, the drug gained popularity before a coronavirus vaccine was available. Doctors can prescribe it but few will do so to treat COVID-19 because of the FDA’s warning against it.

State Rep. John Bucy III, D-Austin, a member of the House Public Health Committee who pressed Shofner about safeguards on the bill last week, said he plans to vote against the bill when it comes before the full House on Wednesday.

“You’re taking the doctor out of the equation,” he said Tuesday, adding that misuse of the drug will continue.

“I do believe in medical freedom for adults but this bill goes beyond that,” Bucy said. “I want to have better information, labeling and we need to protect children and this bill doesn’t do that.”

What is ivermectin?

In the past five years, the number of COVID-19 infections has dropped significantly because of vaccines and the fact that mutated versions of the virus have weakened over time. Yet, the popular clamor for the ivermectin never waned, prompting 15 states, including Texas, to introduce legislation that would allow the sale of the drug without a prescription. So far, four states have passed such bills — Arkansas, Idaho, Louisiana and Tennessee.

Ivermectin was discovered in the 1970s as an effective veterinary drug by Japanese microbiologist Satoshi Ōmura. He and William Campbell were awarded a Nobel Prize in 2015 for their work in developing ivermectin and using it to treat parasites. It’s been used in humans as a treatment for specific parasites in tropical and subtropical regions. It is also used for lice. It acts by paralyzing and then killing the parasite by interfering with its nerve and muscle functions.

In 2020, an Australian study claimed ivermectin had promising antiviral activity in a petri dish against COVID-19, and the use of a long-tested drug against a new disease prompted considerable public interest a full year before a vaccine was available. But the study was found to have used higher doses than recommended in humans and subsequent studies found ivermectin did not have a significant impact on the virus.

Shofner often points to a 2021 study of 72 Bangladesh patients that found it may have eased early COVID-19 symptoms, but that study states that more research needs to be conducted to confirm those preliminary findings.

Still, many people began asking their doctors for the drug and there was an increase in the number of those reporting side effects from using it.

No one needs a prescription to purchase ivermectin from a feed store or tractor supply store, which supplies the medication for livestock use only.

The original version of Shofner’s bill required that pharmacists produce an annual report on the number of times it was dispensed. The committee substitute version that now goes before the Texas House removes that requirement.

Under HB 25, a pharmacist would still have to discuss with patients the possible side effects, including nausea, dizziness and skin rash, before dispensing it.

What supporters, opponents say

Ivermectin can be used in humans but the FDA has tried to dissuade its use for COVID-19, adding that “taking large doses of ivermectin can be dangerous.”

In 2021, two people in New Mexico died who had used ivermectin to treat COVID-19. That state’s health agency chief at the time compared taking ivermectin for COVID-19 to taking an antacid for a heart attack.

But Shofner said that because it is safe and already available, the restrictions should be lifted.

“It would be behind the pharmacy counter, like many of our cold and cough medicines like pseudoephedrine without a prescription,” Shofner said during the committee hearing.

Dozens of supporters of her bill have filed online testimony and appeared in person before the Texas House public health committee to praise ivermectin.

“This is highly important,” insisted Tamara Bergen of Seguin who emailed her support to the house committee. “Ivermectin is extremely safe and has been used all over the world for many treatments. It is effective and should have saved many lives during the COVID pandemic.

“I SUPPORT OTC IVERMECTIN!,” wrote J. Teer, a pastor in Texarkana. “Alternative meds should be avaiable (SIC) at more than vet med sources. This medication was seen as great and its creator won many awards before the so-called pandemnic (sic). We should never be in the situation that we were in during the "covid pandemic." “

But some Democratic lawmakers on the House Public Health committee questioned why this drug and not others.

“I’m concerned about the politicization of this because I think that is why we are seeing such a push,” Bucy said during the hearing. “If we want to change how Texas functions, fine, but to pick and choose which drug we want to get behind to do that is confusing to me.”

Dr. Zeke Silva, a radiologist, speaking for the Texas Medical Association, testified against the bill, saying that he feared it would diminish the doctor’s role in prescribing medication.

“The TMA is concerned that this bill will set a precedent whereby that physician-patient relationship is no longer part of the prescribing of medications, which could have significant side effects,” he said.

Writing a prescription happens only after a doctor has a chance to understand a patient’s medical history, allergies and other factors to determine the best course of treatment.

Noticeably absent from the testimony was the Texas Board of Pharmacy whose members would be directly affected by the bill. The agency did not return a request for comment.

Michelle Evans with Texans for Vaccine Choice said the bill would return the decision-making process to patients.

“HB 25 is simple and long overdue and a shared priority for many in our state, including constituents in each of your districts,” she said. “It would enable Texans to take their health into their own hands.”

Disclosure: Texas Medical Association has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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