Lone Star State Quietly Opens Pharmacy Shelves to Controversial Drug as Patients, Doctors, and Pharmacists Navigate New Freedom and Old Warnings
In the fluorescent hum of a small-town H-E-B pharmacy just outside Austin, 68-year-old retiree James Whitaker slid a $12 box of ivermectin tablets across the counter on the morning of December 1, 2025, no questions asked, no doctor’s note required. The cashier scanned it like aspirin. “First time in my life I’ve ever been able to just walk in and buy something that might help my breathing,” Whitaker said quietly, tucking the white box into a plastic bag beside his groceries. The former truck driver, who still feels the lingering cough from a severe COVID case in 2021, had tried everything from inhalers to honey tea. When he heard Texas House Bill 25 quietly took effect at midnight, he was one of the first through the door. “I’m not trying to be political,” he added, almost apologetic. “I just want to feel normal again.” Across the state, from Laredo to Lubbock, similar scenes unfolded as pharmacists removed the “prescription only” stickers from ivermectin shelves, turning a drug once at the center of a global storm into something as ordinary as ibuprofen—thanks to a law signed by Governor Greg Abbott in August and now, finally, in force.
House Bill 25, authored by Republican state Rep. Cole Hefner of Mount Pleasant, sailed through the Texas Legislature on near-party-line votes before landing on Abbott’s desk. It adds ivermectin to the short list of medications Texans can buy over the counter, joining drugs like emergency contraception and certain nicotine patches. Supporters framed it as simple patient choice: an FDA-approved antiparasitic with a decades-long safety record for river blindness and scabies shouldn’t require a doctor visit when someone wants to try it for other reasons. “Texans know their bodies better than bureaucrats in Washington,” Hefner said on the House floor in May, echoing a sentiment that resonated deeply in a state proud of its independent streak. Abbott, signing the bill without fanfare at a rural clinic, called it “one more way we’re putting medical freedom back in the hands of individuals and their families.”
The change arrives four years after ivermectin became the most polarizing pill on the planet. During the height of the pandemic, when hospital beds filled and vaccine rollout lagged, stories spread like wildfire: a cheap, readily available drug that some early studies—and plenty of personal testimonies—suggested might shorten symptoms or prevent severe illness. Doctors in Peru, India, and parts of Africa added it to treatment protocols. In the United States, telehealth sites and feed-store versions meant for livestock flew off shelves. Then came the backlash. Large, rigorously controlled trials—the 2022 ACTIV-6 study out of Duke, the TOGETHER trial in Brazil, and others—found no meaningful benefit against COVID-19 when taken at human doses. The FDA issued blunt warnings: “You are not a horse.” Poison-control hotlines logged thousands of calls from people who self-dosed with veterinary formulations and landed in emergency rooms with nausea, seizures, even vision loss. Major medical groups—the AMA, the Infectious Diseases Society of America, even the drug’s own manufacturer, Merck—urged the public to stick to proven therapies.
Yet the debate never fully died. In living rooms from Houston suburbs to Panhandle ranches, people kept quiet stashes “just in case.” Some doctors continued prescribing it off-label, citing the ethics of patient autonomy when options felt scarce. Others refused, citing evidence and liability fears. Pharmacists became reluctant gatekeepers, filling scripts warily while turning away walk-ins. HB 25 effectively ends that awkward middle ground. Now any adult in Texas can walk into a CVS, Walmart, or corner mom-and-pop and buy a box—typically 20 tablets of the 3 mg human formulation—for $10 to $30, no questions, no judgment, no waiting for a doctor who might say no.
For James Whitaker and countless others, the new law feels like permission to hope again. “My neighbor swears it knocked his COVID out in two days last winter,” he said outside the pharmacy, squinting into the bright Hill Country sun. “I figured it was worth a try if things get bad this season.” His sentiment echoes across rural Texas, where doctor visits can mean a two-hour drive and skepticism of federal health agencies runs deep. In the East Texas town of Lufkin, pharmacist Laura Nguyen restocked her shelf with 200 boxes the night before the law took effect. By noon on December 1, half were gone. “Mostly older folks, a few young parents worried about flu season,” she said, arranging the remaining boxes neatly beside the Sudafed. “Nobody’s yelling politics. They just want options.”
Doctors, meanwhile, are bracing for a delicate conversation. Dr. Priya Patel, an internal-medicine physician in Plano, spent part of her morning fielding texts from anxious patients. “Some are relieved they don’t have to ask me anymore,” she admitted over coffee between appointments. “Others are asking if it’s safe to take with their blood-pressure meds. My job hasn’t gotten easier—it’s just different.” The Texas Medical Association, while not opposing the bill, issued guidance reminding physicians they can still counsel against off-label use and are under no obligation to recommend it. The American Pharmacists Association sent similar bulletins: counsel patients, document discussions, watch for drug interactions—especially with blood thinners and certain heart medications.
Public-health leaders worry quietly about unintended consequences. Calls to the Texas Poison Center network spiked 300% in 2021 when veterinary ivermectin trended on social media; officials hope the ready availability of human-grade tablets will keep people away from livestock versions sold at tractor-supply stores. The FDA, in a measured statement December 1, reiterated that ivermectin remains unapproved for COVID-19 prevention or treatment but acknowledged states’ rights to regulate pharmacy practice. “We continue to urge the public to rely on vaccines and proven therapeutics,” an agency spokesperson said, striking a tone more resigned than combative.
In pharmacies large and small, the mood is pragmatic. At a bustling Walmart in McAllen, near the Mexico border, pharmacist Miguel Ortiz watched a steady stream of customers—mostly senior citizens and a few construction workers—pick up boxes alongside cough syrup and vitamin C. “I tell everyone the same thing,” Ortiz said, lowering his voice so waiting customers wouldn’t hear. “This is for parasites. For anything else, talk to your doctor. But if they still want it, Texas law says I hand it over.” He shrugged, a small smile tugging at the corners of his mouth. “People have been making their own choices forever. Now it’s just legal.”
For many Texans, the new law lands less as a political statement and more as a quiet return of control. In a state where personal liberty is practically scripture, the ability to walk into a store and buy a medication without jumping through hoops feels like a small victory in a world that often feels out of control. Whether that victory proves wise or risky remains an open question—one that families like James Whitaker’s will answer one cautious dose at a time.
As winter approaches and flu season looms, ivermectin boxes now sit unassuming on Texas shelves, no longer hidden behind the pharmacy counter, no longer whispered about in parking lots. For some, they represent hope wrapped in foil. For others, a reminder that medical freedom and medical evidence don’t always walk the same path. Either way, in the Lone Star State, the choice is now—literally—over the counter.