In the United States, United Kingdom, Canada, Australia, New Zealand and across the European Union, oral ivermectin for human use is a prescription-only medicine. It is not sold over the counter in pharmacies in any of those markets. In a number of other countries — parts of Latin America, South and Southeast Asia, and much of sub-Saharan Africa — it is available from pharmacies without a prescription, and in some regions it is distributed free through public health programmes.
Prescription status is not a judgement that a drug is dangerous. It reflects a regulatory view that correct use requires diagnosis and dosing judgement that a pharmacist cannot supply at the counter.
For ivermectin the specific concerns are that the dose is weight-based and must be calculated, that the correct schedule differs between indications, that a heavy parasite burden can produce a significant reaction to treatment, and that the conditions it treats need to be distinguished from conditions that look similar but need different drugs. Scabies, eczema and contact dermatitis can look alike; treating the wrong one wastes weeks.
There is also a specific safety issue with Loa loa co-infection. In patients with a high Loa loa microfilarial load, ivermectin can precipitate a severe and occasionally fatal encephalopathy. This is why treatment in Central African regions where loiasis is endemic requires screening beforehand.
Pharmacy availability without prescription is common in much of Latin America, parts of South and Southeast Asia, and several countries in Africa where ivermectin is a routine public health medicine.
Mass drug administration programmes distribute ivermectin free of charge to entire communities in onchocerciasis and lymphatic filariasis endemic areas, under the Mectizan Donation Programme. Billions of doses have been distributed this way since 1987, which is the single largest source of human ivermectin exposure worldwide and the basis for much of what is known about its safety at population scale.
Veterinary ivermectin — horse paste, pour-on solutions, cattle injectables — is sold without prescription in many farm supply stores. It is not a substitute for human pharmaceutical product, and the FDA has issued explicit warnings against using it in people.
The problems are concentration, formulation and control. Horse paste is dosed for animals weighing 500 to 600 kg, so a human dose is a small and imprecisely measured fraction of a syringe. The excipients are chosen for palatability to animals and are not evaluated for human ingestion. Manufacturing is to veterinary standards, which do not require the same impurity controls or content uniformity as human pharmaceutical GMP.
This is covered in detail on our human vs veterinary ivermectin page.
Ivermectin 1% cream is likewise prescription-only in the US, UK, EU and Australia. Some countries permit pharmacy sale of topical ivermectin for head lice under pharmacist supervision.
A separate 0.5% lotion is approved in the United States for head lice and is also prescription-controlled.
GMP-certified human formulations — tablets and 1% cream. Never veterinary products. Most USA orders ship within 1–7 business days, with tracking on every order.
View products and pricingNo. Oral ivermectin and ivermectin 1% cream are both prescription-only in the US. Veterinary ivermectin is sold over the counter at farm supply stores but is not intended for and should not be used by people.
No. Ivermectin is prescription-only in the UK. Oral ivermectin is not routinely licensed there for general use and is usually obtained through specialist or named-patient routes.
Pharmacy availability without prescription is common across much of Latin America, parts of South and Southeast Asia, and several African countries. Rules vary and change, so local regulations should be checked directly.
Prescription status reflects the need for diagnosis and weight-based dosing judgement rather than a view that the drug is hazardous. Getting the diagnosis wrong, the dose wrong, or missing a Loa loa co-infection all carry real consequences that a counter sale cannot guard against.
It is legally sold for animals, but it is not an appropriate human alternative. Concentrations are calibrated for animals ten times human body weight, the excipients are not evaluated for human use, and manufacturing follows veterinary rather than human pharmaceutical standards. The FDA has warned against it explicitly.