When you visit the “COVID-19 Info” page on Austin Compounding Pharmacy’s website, it tells you in no uncertain terms that “taking Ivermectin once a week will decrease your risk of infection and reduce the severity if you do contract COVID-19.” There is no evidence that is true.
The Texas pharmacy also has a special order form that lists 10 COVID-19 medications, none of which has been approved by the Food and Drug Administration to treat or prevent the disease. Ivermectin is at the top, followed by hydroxychloroquine (which has been proved to be ineffective against COVID), and a list of non-prescription items to create your own “Corona Six Pack.” The choices include zinc, melatonin and a pulse oximeter because, according to the form, “Oxygen saturation is important.”
Ivermectin as a cure for COVID has proved to be a surprisingly durable myth, with people across the country continuing to jump through hoops to get their hands on it, despite warnings from the FDA, the Centers for Disease Control and Prevention and state pharmacy boards that it does not work on the coronavirus. Humans can take the anti-parasitic drug in pill form, and it is available in large, over-the-counter quantities for livestock.
The medicine has been boosted by big names, including controversial podcaster Joe Rogan and Infowars founder Alex Jones. At least two people have died after taking ivermectin instead of being properly treated for COVID, but some brick-and-mortar pharmacies are risking their reputations and patients’ safety by continuing to dispense it, filling prescriptions generated by sometimes-shady practices.
And the right-wing media machine is making sure people are aware that if you want it badly enough, there are absolutely ways to get ivermectin. In September, Fox News host Tucker Carlson asked psychiatrist Mark McDonald to give his audience pointers on how to access human-grade ivermectin. “It depends on where you go,” the anti-vaccine doctor said. “Chain pharmacies: very, very difficult. Small pharmacies, independents, compounding pharmacies have supplies. So you can get it if you look for it. But you often have to make many, many phone calls.”
It actually doesn’t take as many calls as McDonald seems to think. A HuffPost investigation found dozens of independent community pharmacies dispensing ivermectin, and many, as McDonald suggested, are compounding the drug themselves — that is, purchasing ingredients from a wholesale distributor, combining them on their premises and putting the mixture into capsules. Unlike ivermectin straight from the manufacturer, these capsules are not FDA-approved. According to one widely shared list, at least 76 pharmacies in 28 states (including 15 in Florida) and five countries are filling prescriptions.
But the list is by no means exhaustive: Online, people are sharing information on other pharmacies that, they say, have been happy to oblige their ivermectin search. These pharmacies have made the conscious decision to buck the science to meet a soaring demand, cashing in on the drug’s enduring time in the spotlight.
Where And How
By the time the ivermectin craze reached its peak in late summer, “quack telehealth prescribers” (as one pharmacist in Maine put it to Time magazine) were indiscriminately doling out prescriptions to people willing to pay for a consult. The Frontline Covid-19 Critical Care Alliance (FLCCC) — which has played a major role in promoting ivermectin, as HuffPost recently reported — created the list of 78 pharmacies to point would-be customers in the direction of businesses willing to distribute ivermectin for off-label use. Most of them are real-life, in-person operations, and most are strictly compounding pharmacies or have compounding capabilities.
Many of the pharmacies on the FLCCC list confirmed to HuffPost that they are compounding ivermectin themselves. But this practice extends much further: When HuffPost reached out to a random selection of seven other compounding pharmacies across the country, five said they would create ivermectin pills for customers with a prescription, one said it only had tablets and one said it would not fill any prescription of ivermectin meant to treat or prevent COVID-19.
Though one pharmacist was eager to ensure that the powder they use meets regulatory standards, the FDA explicitly states that compounded drugs are not approved by their organization. And a number of the pharmacy sites feature this same warning. But it hasn’t stopped people from seeking it out.
Compounding pharmacies are by far the easiest way to get ivermectin for COVID. Professionals at retail pharmacies can usually tell when an ivermectin prescription isn’t intended to treat parasites (which is its primary governmentally approved use).
“When you look at the dose used for roundworm, it’s usually a single dose, a few tablets max, maybe repeated a few times,” Anne Burns, a pharmacist and vice president for practice affairs at the American Pharmacists Association, told HuffPost, referring to one of the drug’s FDA-approved uses. “The way it’s being dosed for COVID-19 is several tablets or more a day, or over multiple days. There’s a pretty significant discrepancy.”
The compounding pharmacies freely filling ivermectin prescriptions are not shy about it. Austin Compounding Pharmacy offers a $100 one-hour COVID care consultation with pharmacist and owner Tom Schnorr, who recently told local media that the pharmacy is receiving 300 prescriptions per day. “If you treat it when you get infected, you don’t have to go to the hospital,” he said of ivermectin and COVID. (Major medical associations contradict claims like these.) Below their prescription request form, there’s another page with a copy of the FLCCC’s I-MASK+ COVID prevention protocol, which, as HuffPost previously reported, helped popularize ivermectin as a COVID-19 cure in the U.S.
“A medication should really only be compounded because it needs a special dose, a special dosage form or because of an allergy.”
- Kathryn Seelman, owner of Twelve Corners Apothecary in Rochester, New York
Town & Country Compounding Pharmacy in Ramsey, New Jersey, has also gone all in on ivermectin. Its website features a pop-up that asks “Interested in ivermectin?” and directs visitors to a “frequently asked questions” page, which includes a link to the FLCCC’s list of known prescribers. In a YouTube video posted in late August, during the delta variant surge, owner John Herr name-checks the FLCCC and encourages patients to follow its protocol.
Similarly, one Pensacola, Florida, compounding pharmacy on the list has a special ivermectin section on its website linking to a request form. Another in Wichita, Kansas, has ivermectin information on its homepage, including the doses its pharmacists are currently making.
Other pharmacies are also ready and waiting to provide this information to inquiring customers. The recording at one independent pharmacy in Charlotte, North Carolina, features a voice recording instructing callers to “press zero [if] you’re calling about ivermectin,” before patching through a member of their staff. At another in Prescott, Arizona, the hold message encourages callers to ask about ivermectin.
Pharmacies in Kennett Square, Pennsylvania, and Jacksonville, Florida, confirmed in late September that they were selling both ivermectin tablets and compounded capsules but predicted they wouldn’t have any by mid-October because supplies were backordered.
And when reached by phone, pharmacies from New Jersey to Pennsylvania to Florida to Colorado all confirmed to HuffPost that they were compounding prescriptions in lieu of the manufactured tablets to allow for customized dosages and to meet demand. The person who answered the phone at one business even said of compounded ivermectin, “Personally, I think it’s better” — because it’s more “pure.”
No Consequences
Ivermectin is manufactured by the U.S. pharmaceutical company Merck as well as other generic manufacturers, and it’s distributed internationally. When asked if the company was aware of compounding pharmacies ordering wholesale ivermectin ingredients to make their own capsules — and whether it had any plans to stop it — Merck referred HuffPost to a general statement about ivermectin use issued in February.
Government regulators are aware of widespread ivermectin use but have not done much to stop it. In a statement to HuffPost, FDA spokesperson Jeremy Kahn said the agency is “aware that some compounders may be advertising or producing ivermectin for uses related to COVID-19. The FDA strongly advises against this activity. At this time, the safety and efficacy of ivermectin for the prevention or treatment of COVID-19 has not been established.”
But when further pressed about whether the agency plans to crack down on the off-label compounding, the FDA wouldn’t comment further.
Kathryn Seelman, owner and pharmacist at Twelve Corners Apothecary in Rochester, New York, has worked in pharmacies for 20 years and has run her own compounding pharmacy for the last six. She said she’s gotten many requests for ivermectin but has refused to compound it for COVID-19, noting that most of the requests have come from new patients she’s never worked with before.
“A medication should really only be compounded because it needs a special dose, a special dosage form or because of an allergy,” Seelman told HuffPost. “There’s really no reason pharmacies are not using commercially available products with doses we know to be safe.”
Though some compounding pharmacies reached by HuffPost claimed they turned to compounding because of a supply issue, Seelman said she’s seen no evidence of an ivermectin shortage and is able to get it directly from manufacturers if needed. “Some pharmacies are more willing to take the risk and make money off it,” she said.
The Grift
The business of prescribing ivermectin has proved to be remarkably lucrative for right-wing medical groups and telemedicine platforms, such as America’s Frontline Doctors (AFLDS). As The Intercept reported this month, customers pay “$90 for a phone consultation with ‘AFLDS-trained physicians’ who prescribe treatments such as hydroxychloroquine and ivermectin to prevent and treat Covid-19.” The meds are delivered by Ravkoo, a drug delivery service that works with local pharmacies.
According to The Intercept’s math, AFDS has made nearly $7 million on consultations alone. And a Time report earlier this month revealed that Ravkoo has made approximately $8.5 million off of filling unproven COVID-19 treatments — chief among them ivermectin.
Meanwhile, the feverish accusations of conspiracies — by the government, by pharmaceutical companies, by the global elite — preventing proper COVID treatment continue. In late September, Rep. Louie Gohmert (R-Texas) wrote an opinion article headlined: “The Coordinated Attack on Ivermectin Is a Crime Against Humanity.”
“What the globalist elites and the medical establishment won’t tell you is that those who discovered ivermectin and its use to treat parasitic diseases won a Nobel Prize in 2015 — it was the Nobel Committee for Physiology or Medicine’s only award for treatments of infectious diseases in six decades,” Gohmert wrote in the Sept. 29 article on the conservative website American Greatness.
And though there are still only a relatively small handful of pharmacies filling these off-label prescriptions, proponents of ivermectin — mostly conservative political and media personalities — have begun to criticize pharmacists who refuse.
Former Trump administration communications adviser Mercedes Schlapp recently tweeted, “Doctors are finding it more and more difficult to prescribe Ivermectin through the pharmacies. @GOP leaders should do what they can to ensure that patients should not be denied access to prescribed medication. There should be an investigation into this.” Her husband, Matt Schlapp, chair of the American Conservative Union, chimed in a few days later: “Doctors who are prescribing Ivermectin can’t find pharmacies to fulfill it. Any therapeutic that is proven to work is cancelled.”
Customers hyped up on ivermectin disinformation are applying pressure of their own. Burns, of the American Pharmacists Association, said, “We’ve heard from many pharmacists pressured by patients and pressured by doctors to fill them.” Though she did not provide specific details about the incidents, she said that patients in locations throughout the country have reportedly been “irate” and have demanded that a pharmacist fill their prescription. One video posted to Twitter last week shows a customer repeatedly telling a pharmacist that not filling his ivermectin prescription is “against the law.” (“No, it’s not,” the pharmacist replies, correctly.)
Aggressive demand for ivermectin will continue as long as organizations like the AFLDS and the FLCCC keep pushing it, and as long as local news organizations keep publishing stories with headlines like “Woman Says Controversial COVID-19 Treatment Ivermectin Saved Her Life.” With doctors readily available to make a quick buck on a simple phone consultation, vaccine skeptics will continue to seek alternatives — and, in many cases, their local pharmacy will be all too happy to help.