New Hampshire Pharmacies Could Soon Dispense Ivermectin Without Doctor Approval

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New Hampshire residents may soon be able to receive ivermectin from pharmacies without first getting a prescription or approval from a doctor.

Proposed legislation titled House Bill 1022 would allow pharmacists to dispense the drug, which some believe can treat COVID-19 even though it lacks approval for such use from the U.S. Food and Drug Administration (FDA), by means of standing orders.

Under the law, pharmacists would be able to “dispense ivermectin under the delegated prescriptive authority of the physician or APRN (Advanced Practice Registered Nurses), specify a mechanism to document screening performed and the prescription in the patient’s medical record, and include a plan for evaluating and treating adverse events,” according to the bill.

“Any such prescription shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.”

The pharmacist would also be required to provide any patients who receive ivermectin with a “standardized information sheet written in plain language” that provides health care referral information and notes the importance of follow-up care.

“Nothing on the information sheet shall discourage the recipient from using ivermectin for the treatment of COVID-19,” the bill read.

According to the legislation, the measure would take effect 60 days after it was passed.

The FDA has not approved ivermectin for the treatment or prevention of COVID-19 in both humans and animals, according to its website. It is, however, “approved for human use to treat infections caused by some parasitic worms and head lice and skin conditions like rosacea.”

The agency said that while clinical trials to assess the effectiveness of ivermectin against COVID-19 were taking place, current data does not indicate that is the case. It also said that taking large doses of the drug is dangerous, and instructed anyone who receives an ivermectin prescription to “fill it through a legitimate source such as a pharmacy, and take it exactly as prescribed.”

Some are pushing back against the legislation, including Jeffrey Poirier, whose Twitter bio says he is a registered pharmacist in New Hampshire.

“This goes against the recs of NHSHP (New Hampshire Society of Health-System Pharmacists), the FDA & the CDC. Desperation is pervasive, even in the face of the advice against it from our pharmacy leaders,” he wrote in a tweet Wednesday.

A number of medical experts testified in opposition to the bill during a legislative session on Tuesday.

“I’d like to believe the standard of care here in New Hampshire is that a patient could get a prescription for ivermectin, off-label, as long as that patient ideally gets put into some clinical trial, whether it’s a drug company or whether it’s an academic institution like Dartmouth,” Dr. Nick Perencevich, a retired general surgeon, said during his testimony.

Republican State Rep. Leah Cushman, a sponsor of the bill and registered nurse, stated that she wanted to make sure residents of the state “have options for treatment of COVID-19.” She also said that the burden of the virus on hospitals needs to be curbed, “and right now there are no early treatments being offered by most doctors.”

In regard to some of the pushback against the bill, Cushman said that the House committee was working on a bipartisan amendment to address some of the concerns. This includes requiring that patients who receive the drug are informed that its use for COVID-19 is “off-label” and setting guidelines for tracking any adverse effects, she said.

“I think we can work together to get it an Ought to Pass recommendation from the committee,” Cushman said.

The FDA has, however, stressed that even levels of ivermectin approved for human use can have potentially harmful effects when they interact with other medications, such as blood thinners. Additionally, an overdose on ivermectin can cause nausea, vomiting, diarrhea, low blood pressure, seizures, coma, and even death, according to the agency.

“There’s a lot of misinformation around, and you may have heard that it’s okay to take large doses of ivermectin. It is not okay,” the FDA said on its website.

The New Hampshire legislation is currently in committee, but the state House of Representatives is slated to vote on it in the coming weeks, WMUR reported.