I fortunately have a local dr who presribes it anytime for me. The capsules are filled fresh at a local pharmacy. I take a basic regime twice a year. I travel, eat a lot of things, have hands in the dirt and am around animals.

As a farmer I have gone far down the path of using beneficial fungi/compost teas etc for soil fertility. Finding that Ivermectin was derived from beneficial soil fungi made complete sense to me.