Tennessee Pharmacies Sell High-Dose Ivermectin Without Prescriptions
Four years after passing the nation’s first ivermectin-without-prescription law, Tennessee pharmacies are selling pills at up to 20 times standard strength — with an anti-vaccine doctor at the center of the network.
NASHVILLE, TENNESSEE — Tennessee remains the only state in the country where adults can walk into a pharmacy and purchase ivermectin without first visiting a doctor, a policy now four years old that has led to a loosely regulated market for the antiparasitic drug, including pills sold at 10 to 20 times standard prescription strength.
Pharmacies across the state use a pre-written, blanket prescription to dispense the drug to nearly anyone who requests it. Highway billboards advertise ivermectin as “Available Without a Prescription in Tennessee!” and the drug is sold in roadside shops and small-town strip malls with little oversight from health authorities, according to Tennessee Lookout and KFF Health News reporting.
A Drug With a Contested History
Ivermectin is a Nobel Prize-winning antiparasitic medication approved by the U.S. Food and Drug Administration for treating parasitic diseases in humans. A standard course of treatment typically requires a single dose of three or four prescription-strength tablets. The drug is also widely used as a dewormer for horses and other livestock.
The drug’s public profile surged during the COVID-19 pandemic, when fringe physicians and anti-vaccine activists promoted it as a treatment for the virus. Clinical trials have since shown ivermectin does not provide meaningful benefits against COVID-19, but its popularity in certain circles persisted.
Dozens of Tennessee pharmacies now offer highly concentrated formulations of the drug, with some pills carrying 10 or 20 times the potency of a standard tablet. The arrangement is made possible by the state’s 2022 law, which was the first of its kind in the United States.
An Anti-Vaccine Doctor at the Center
Much of the pharmacy network dispensing high-dose ivermectin across Tennessee operates with the involvement of an anti-vaccine physician who has publicly described taking “bucketloads” of the drug, according to the Tennessee Lookout report. The outlet identified this doctor as a central figure enabling dozens of pharmacies to participate in ivermectin sales under the state’s blanket prescription framework.
Compound Rx, located in Cookeville, Tennessee, is among the dozens of pharmacies in the state offering ivermectin without patient-specific prescriptions, according to KFF Health News photographer Brett Kelman, who documented the location. Some pharmacies advertise the drug as available over the counter, even though customers are technically required to request it from a pharmacist.
Oversight Questions Remain
Health authorities have exercised little oversight of the market that has developed under the 2022 law, according to the Tennessee Lookout. The combination of a blanket prescription system, high-potency formulations, and minimal regulatory scrutiny has drawn attention from health reporters examining how the state’s policy plays out in practice.
Ivermectin is considered generally safe when used at approved dosages for its FDA-cleared purposes. The concern raised by the reporting centers on the availability of highly concentrated formulations dispensed without individualized medical evaluation, and the role of at least one physician whose views on vaccines and the drug itself fall outside mainstream medical consensus.
Tennessee Lookout’s full investigation, produced in partnership with KFF Health News, was published on June 17, 2026.
