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aciclovir + hydrocortisone (Xerese / Xerclear / Lipsovir)

✓ Approved

Lapidot Medical · NR3C1 · Small Molecule

What is aciclovir + hydrocortisone?

aciclovir + hydrocortisone is a small molecule developed by Lapidot Medical. It is approved for therapeutic indications via topical.

Drug Profile

Brand NamesXerese, Xerclear, Lipsovir
CompanyLapidot Medical
Drug ClassSmall Molecule
Molecular TargetNR3C1, ,
RouteTopical
StatusApproved
Sources: ClinicalTrials.gov, Lapidot Medical

Mechanism of Action

Molecular Targets

aciclovir + hydrocortisone acts on 3 molecular targets:

NR3C1nuclear receptor subfamily 3 group C member 1 (GR, GCCR)
(UL30)
(UL30)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

aciclovir + hydrocortisone is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Congenital, familial and genetic disordersCongenital herpes simplex infection✓ Approved

Related Research Articles

PubMedJCEM case reports2026-10-14

Long-term cyclic ectopic adrenocorticotropic hormone syndrome with extreme fluctuations and adrenal insufficiency.

Choi Soon Young SY, Chin Hyounjung H, Yoo Soyeon S, Lee Sang Ah SA et al.

A 77-year-old woman presented with worsening glycemic control and hypokalemia and was found to have adrenocorticotropic hormone (ACTH)-dependent hypercortisolism with loss of diurnal cortisol variation and failure of suppression on low- and high-dose dexamethasone suppression tests. Computed tomography (CT) demonstrated bilateral adrenal enlargement, whereas pituitary magnetic resonance imaging and chest CT failed to identify a source of ACTH secretion, leading to a diagnosis of occult ectopic ACTH syndrome. During 15 years of follow-up, she exhibited cyclic fluctuations in ACTH and cortisol concentrations, including episodes of severe hypercortisolism with ACTH levels exceeding 2000 pg/mL (>440 pmol/L) (reference range, 7.2-63.6 pg/mL [1.6-14.0 pmol/L]) and cortisol concentrations of 30-60 μg/dL (828-1656 nmol/L) (reference range, 6.2-19.4 μg/dL [171-535 nmol/L]), alternating with spontaneous remission. Serial imaging revealed dynamic adrenal morphological changes, with enlargement during hypercortisolemic phases and regression during remission. During treatment with ketoconazole, mitotane, and osilodrostat, the patient experienced recurrent significant hypocortisolic episodes, some of which were likely treatment-associated and required hydrocortisone replacement therapy. This case highlights an exceptionally prolonged course of cyclic ectopic ACTH syndrome characterized by extreme hormonal oscillation, reversible adrenal hyperplasia, and recurrent hypocortisolism, emphasizing the importance of long-term biochemical surveillance and individualized therapeutic adjustment.

PMID 42871353
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PubMedFrontiers in oncology2026-10-14

Case Report: Immune checkpoint inhibitor-induced hypophysitis presenting as acute paralytic ileus mimicking mechanical bowel obstruction in a patient affected by advanced non-small cell lung cancer.

Baggi Alice A, Adriani Anna A, Ammoni Luca Carlofrancesco LC, Carola Giorgia G et al.

Immune checkpoint inhibitors (ICIs) have significantly improved outcomes in advanced non-small cell lung cancer (NSCLC) but may induce immune-related adverse events (irAEs), including hypophysitis. Although endocrine irAEs usually present with nonspecific constitutional symptoms, atypical manifestations may delay diagnosis and expose patients to unnecessary invasive procedures. We report the case of a 76-year-old man with metastatic NSCLC receiving first-line nivolumab, ipilimumab, carboplatin, and pemetrexed who developed profound asthenia, altered mental status, bilious vomiting, and severe gastrointestinal dilation suggestive of acute mechanical bowel obstruction after two treatment cycles. Computed tomography demonstrated marked gastric and intestinal distension, and surgical management was initially considered. Endocrine evaluation subsequently revealed central hypothyroidism and secondary adrenal insufficiency, consistent with ICI-induced hypophysitis. Prompt initiation of physiological hormone replacement with intravenous hydrocortisone followed by thyroid hormone supplementation resulted in rapid neurological and systemic recovery, complete restoration of gastrointestinal motility, radiological resolution of bowel dilatation, and avoidance of surgery. Follow-up imaging also demonstrated a partial tumor response, which has remained durable for more than two years without additional anticancer treatment while the patient continues long-term endocrine replacement therapy. This case expands the clinical spectrum of ICI-induced hypophysitis by describing an unusual presentation as acute paralytic ileus mimicking mechanical bowel obstruction. It underscores the importance of maintaining a high index of suspicion for endocrine irAEs in patients receiving ICIs who develop unexplained multisystem deterioration or apparent surgical abdomen. Early hormonal assessment and timely replacement therapy can be lifesaving, prevent unnecessary surgical interventions, and allow optimal multidisciplinary management without compromising oncologic outcomes.

PMID 42871183
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PubMedZhonghua wei zhong bing ji jiu yi xue2026-10-14

[Successful treatment of myocardial infarction complicated with thyroid crisis using extracorporeal membrane oxygenation: a case report and literature review].

Zhang Liang L, Piao Yihua Y, Piao Xianji X

Thyroid crisis is caused by an excess of thyroid hormones in the body, leading to a hypermetabolic state and a series of pathological and physiological changes. Clinical manifestations are often non-specific, and in severe cases, it can manifest as multiple organ dysfunction. Acute myocardial infarction combined with thyroid crisis is dangerous and has a high mortality rate. Timely identification and combination of mechanical circulatory support and antithyroid drug treatment are key to improving prognosis. On January 28, 2021, a 49-year-old female patient was admitted to Yanbian University Affiliated Hospital due to "altered mental status for 4 hours, cardiopulmonary during this period". After cardiopulmonary resuscitation, her vital signs were extremely unstable, and electrocardiogram and myocardial enzymes showed acute non-ST-segment elevation myocardial infarction with severe heart function decline (ejection fraction 26%). On the third day of admission, she underwent veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support, and on the sixth day, she underwent percutaneous coronary stent implantation. After surgery, the patient continued to experience recurrent persistent hyperpyrexia and profuse diaphoresis. Screening revealed a significant increase in thyroid hormones and inhibition of thyroid-stimulating hormone. Combined with thyroid ultrasound and Burch-Wartofsky score>45 points, the diagnosis was confirmed to be hyperthyroidism and thyroid crisis. Subsequently, treatment was given with propylthiouracil, propranolol, and hydrocortisone. On the 9th day of admission, extracorporeal membrane oxygenation (ECMO) was successfully withdrawn, cardiac function recovered (ejection fraction of 60%), consciousness improved, and finally the patient was weaned off the ventilator and transferred to a primary hospital for rehabilitation. After 3 months of follow-up, normal life and work were resumed. This case study suggests that early application of ECMO combined with antithyroid therapy can significantly improve the prognosis of patients with refractory cardiogenic shock and thyroid crisis. Even without a clear history of hyperthyroidism, acute coronary events may trigger crisis, and clinical vigilance should be maintained.

PMID 42875246
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PubMedFrontiers in fungal biology2026-10-14

Case report: Fatal hematogenous gastrosplenic mucormycosis in an immunocompetent adult following sigmoid perforation, septic shock, and short-term stress glucocorticoids.

Liu Jiewei J, Zhang Wei W, Chen Hua H

Mucormycosis is an aggressive angioinvasive fungal infection that predominantly affects chronically immunosuppressed individuals. Hematogenous dissemination of Mucorales causing synchronous gastric full-thickness perforation and total splenic infarction is exceptionally rare, particularly in immunocompetent hosts without chronic comorbidities. To our knowledge, this presentation has not been reported in a patient with only three days of stress-dose glucocorticoid therapy following sigmoid perforation and septic shock. We report a fatal case of synchronous gastric perforation and total splenic infarction secondary to hematogenous Mucorales dissemination in a previously healthy adult who developed septic shock from spontaneous sigmoid perforation. The patient received only three days of guideline-recommended stress-dose hydrocortisone and had no pre-existing diabetes, malignancy, or organ transplantation. Routine serum 1,3-β-D-glucan testing and peritoneal fungal cultures were both negative. Empirical micafungin, an echinocandin, was administered for eight days before liposomal amphotericin B was initiated, during which time progressive fungal angioinvasion led to irreversible multi-organ failure and death. Histopathology confirmed broad, aseptate, right-angle branching hyphae invading gastric and splenic vessels, whereas no fungal elements were detected at the primary sigmoid lesion, supporting a predominantly hematogenous dissemination pathway without primary intestinal fungal colonization - an unprecedented finding that fundamentally distinguishes this case from classic primary gastrointestinal mucormycosis. These histopathological findings are biologically consistent with the CotH3 (CotH family protein 3) - GRP78 (glucose- regulated protein 78 kDa) host-fungal virulence axis, which represents a plausible mechanistic explanation for multi-organ angioinvasion observed in this patient. This case delivers three critical clinical takeaways. First, even brief stress-dose glucocorticoids may induce sufficient transient immune paralysis to permit life-threatening hematogenous mucormycosis in patients without chronic underlying immunosuppression, acting as one potential contributing factor alongside sepsis-related critical-illness immune dysfunction. Second, empirical carbapenem plus echinocandin regimens, commonly used in ICUs, lack activity against Mucorales; prolonged reliance on this combination can result in irreversible fatal visceral injury. Third, negative peritoneal fungal cultures and serum 1,3-β-D-glucan do not exclude intra-abdominal mucormycosis; early re-laparotomy for histopathological biopsy is essential in refractory cases.

PMID 42871092
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PubMedAME case reports2026-10-14

Thyroid storm revealing suspected evolving autoimmune polyglandular syndrome type 2 with steroid-limited assessment of autoimmune adrenal insufficiency: a case report.

Salgueiro Ruben R, Salgueiro Fábio Rêgo FR, Lopes Gonçalo G, Tenreiro Patricia P et al.

Autoimmune polyglandular syndrome type 2 (APS-2) is a rare autoimmune disorder characterized by the coexistence of autoimmune adrenal insufficiency with autoimmune thyroid disease and/or type 1 diabetes mellitus. Its heterogeneous and progressive presentation frequently delays diagnosis, particularly during acute endocrine emergencies where one dominant manifestation may obscure concurrent glandular dysfunction. Recognition of evolving autoimmune disease before overt adrenal insufficiency develops remains particularly challenging, especially when emergency corticosteroid therapy is initiated before endocrine evaluation. We report the case of a 53-year-old woman admitted with severe thyrotoxicosis presenting with marked weight loss, persistent vomiting, generalized weakness, and sinus tachycardia. Laboratory evaluation demonstrated suppressed thyroid-stimulating hormone and markedly elevated free thyroxine levels, fulfilling the clinical criteria for suspected thyroid storm, prompting immediate treatment with hydrocortisone, propranolol, thiamazole, and intravenous fluids resulted in rapid clinical improvement. Further investigation confirmed Graves' disease with positive anti-thyroid antibodies and diffuse uptake on thyroid scintigraphy. Additional studies revealed hypercalcemia with suppressed parathyroid hormone levels, vitamin B12 deficiency, positive anti-parietal cell antibodies, and autoimmune atrophic gastritis compatible with pernicious anemia. Biochemical confirmation of primary adrenal insufficiency was not possible because glucocorticoid therapy had been initiated before adrenal function testing. Nevertheless, the presence of anti-21-hydroxylase antibodies strongly supported autoimmune adrenalitis and raised suspicion for evolving APS-2. Extended autoimmune testing also demonstrated positivity for anti-gp210 antibodies and anti-triple tissue antibodies, suggesting latent autoimmune hepatobiliary involvement. Although these findings were not diagnostic of hepatobiliary or additional gastrointestinal autoimmune disease, they supported a broader autoimmune phenotype and highlighted the need for long-term multidisciplinary surveillance. This case highlights the diagnostic challenge of recognizing evolving APS-2 during an acute endocrine emergency, when severe thyrotoxicosis predominates and early corticosteroid therapy appropriately prioritized patient stabilization but limited definitive biochemical assessment of adrenal function. Compared with previously reported cases, this report emphasizes the value of identifying autoimmune adrenalitis before overt Addison's disease becomes clinically apparent and illustrates the importance of comprehensive autoimmune evaluation in patients presenting with severe thyrotoxicosis and multiple autoimmune manifestations. Early recognition, comprehensive autoimmune investigation, and multidisciplinary longitudinal follow-up are essential to prevent potentially life-threatening endocrine complications.

PMID 42871736
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PubMedNatural product research2026-10-13

Norsesquiterpenoids from Melicope pteleifolia (champ. ex benth.) hartley and their potential anti-HIV and anti-inflammatory activities.

Zhou Jun-Yu JY, Pan Xi-Yu XY, Gu Shu-Miao SM, Su Wen-Yao WY et al.

An investigation of the chemical constituents from Melicope pteleifolia (Champ. ex Benth.) Hartley yielded eight norsesquiterpenoids, including one previously undescribed compound designated melipteleinoid (1) and seven recognised norsesquiterpenoids (2-8). The structure of melipteleinoid (1) was determined through comprehensive spectral analyses, whereas the recognised isolates (2-8) were assigned through comparison to previously reported spectroscopic data. All isolates (1-8) were subjected to biological evaluation. Their anti‑HIV and anti‑inflammatory effects were specifically examined. Compounds (1-8) exhibited potent inhibition against HIV-1 reverse transcriptase, whose EC50 values fell between 0.22 and 7.59 µM. Moreover, all isolates (1-8) potently inhibited NO production, with IC50 values on par with those of the reference drug hydrocortisone.

PMID 42868329
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