On 11 September 2021, based on the advice of the Advisory Committee on Medicines Scheduling, the TGA placed restrictions on the prescribing of oral ivermectin (tablet dosage form) by general practitioners through a new listing in Appendix D of the Poisons Standard. This restriction were removed on 1 June 2023.
Ivermectin is not approved for use in prevention or treatment of COVID-19 in Australia.
Stromectol (ivermectin 3mg tablets) is TGA-approved for the treatment of onchocerciasis (river blindness), intestinal strongyloidiasis (threadworm of the intestines) and scabies. All medical practitioners can continue to prescribe oral ivermectin for the approved indications. However, prescribing for non-approved indications (e.g. rare parasitic conditions) have not been limited to specialists from 1 June 2023.
As with all dispensing activities, pharmacists presented with prescriptions for ivermectin need to be satisfied a medicine is safe and therapeutically appropriate prior to supply of the medicine (Professional Practice Standards, 2023).
Further information regarding the scheduling change is available at:
Evidence for use of ivermectin
The approved indications in Australia for ivermectin are for the treatment of roundworm infections, scabies and inflammatory rosacea.
Implications for pharmacist practice
Current Australian advice includes the following:
- The National COVID-19 Clinical Evidence Taskforce has issued the recommendation: “Do not use ivermectin for the treatment of COVID-19.”
- Advice has also been issued by the TGA that ivermectin has not been approved in Australia (or other OECD countries) to prevent or treat COVID-19 disease, and should not be imported for this indication.
Some doctors may decide to prescribe ivermectin for off-label use taking into account potential risks and benefits and with appropriate informed consent. However, given the lack of evidence to support use of ivermectin for COVID-19, it would be difficult for a pharmacist to professionally justify off-label supply of ivermectin for COVID-19 outside of a well-designed clinical trial.
Therefore, PSA recommends that pharmacists do not supply ivermectin for the treatment or prevention of COVID-19. Should pharmacists be unable to establish intended use of an ivermectin prescription, supply should also be declined.