Tennessee Pharmacies Sell High-Potency Ivermectin Without Individual Prescriptions Under 2022 Law

Tennessee became the first state to permit adults to obtain ivermectin directly from pharmacies via pre-written prescriptions without a prior physician visit. The law grants pharmacists immunity from liability and has produced highway billboards and online marketing for unapproved uses including long COVID, diabetes, and cancer. Sales occur in concentrated formulations that exceed FDA-approved single-dose regimens for parasitic infections by large margins.

Poison control data show more than 60 ivermectin exposure calls in Tennessee so far this year, a modest but measurable uptick following the statute. A UCLA observational study documented increased prescribing of ivermectin and related antiparasitics in Southern states after a January 2025 Joe Rogan episode featuring unverified cancer-cure anecdotes. No randomized trial supports efficacy for these off-label indications.

The policy emerged from Republican legislative majorities and aligned medical-freedom groups that promoted ivermectin during the pandemic despite negative trial results. Similar bills have been introduced in more than two dozen states. Public-health analysts note that immunity provisions reduce external oversight while social-media amplification sustains demand among audiences already skeptical of conventional oncology and infectious-disease guidance.

Next steps include tracking whether poison-center volume crosses 100 annual calls and whether neighboring states adopt comparable statutes before the 2027 legislative sessions. FDA adverse-event monitoring and state board audits of dispensing volumes will determine if concentrated formulations require additional age or quantity restrictions.