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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

PubMedCureus2026-07-16

Diagnosis of Pituitary Stalk Interruption Syndrome in a Newborn Presenting With Recurrent Hypoglycemia: A Rare Case Report.

Albadr Fahad F, Alwahhabi Aljohara A AA, Alraeesi Noura N, Gamlo Hussain H et al.

Pituitary stalk interruption syndrome (PSIS) is a rare congenital anomaly associated with multiple pituitary hormone deficiencies. It is characterized by an absent or thin pituitary stalk, an ectopic posterior pituitary, and a hypoplastic anterior pituitary and is typically diagnosed via MRI. The syndrome presents variably depending on age, with neonatal cases often manifesting as recurrent hypoglycemia. Early diagnosis is critical to prevent severe complications. We report a case of a preterm male neonate born via emergency cesarean section due to non-reassuring cardiotocography and vaginal bleeding in the setting of breech presentation. The neonate developed recurrent hypoglycemia despite glucose therapy. Endocrine evaluations indicated hypopituitarism, with low cortisol, growth hormone, and adrenocorticotropic hormone (ACTH) levels. MRI confirmed PSIS with a hypoplastic anterior pituitary, absent pituitary stalk, and ectopic posterior pituitary. Hormonal replacement therapy with hydrocortisone, levothyroxine, and growth hormone led to clinical stabilization. PSIS should be considered in neonates with unexplained hypoglycemia. Early MRI evaluation and prompt hormonal replacement therapy are vital for preventing complications and improving outcomes. Increasing awareness among clinicians can enhance diagnostic accuracy and optimize patient care.

PMID 42460215
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PubMedClinical practice and cases in emergency medicine2026-07-16

A Case Report of Delayed, Severe, Paroxysmal Muscle Cramping After Chilean Rose Tarantula (Grammostola rosea) Envenomation.

Gooley Brian B, Hughes Kirk K, Gooley Mark M, Keyler Daniel D et al.

Grammostola rosea (Chilean rose tarantula) is a common exotic pet belonging to the Theraphosidae (tarantula) family. Case reports of theraphosid bites in adults commonly describe local tissue damage and local pain. Muscle spasms have also been described as a result of the bites but are rarer. We present a case of severe and persistent muscle spasms after a G rosea bite, which is uncommonly reported in the literature. A 42-year-old woman was holding a G rosea tarantula when she was bit on the forearm. Within hours, severe local muscle cramping occurred. Due to worsening cramping, she initially presented to the emergency department the day after the bite, and again on the following day. She was admitted on her second visit and treated with diazepam, cephalexin, diphenhydramine, baclofen, cefpodoxime, doxycycline, prednisone, and topical hydrocortisone. Her laboratory testing was unremarkable, and while medical management may have mildly improved her symptoms, painful cramping persisted. After discharge, her paroxysmal muscle cramping continued for four weeks before completely resolving. While local tissue damage and pain are common, G rosea bites may lead to severe muscle cramping that persists for weeks. Standard laboratory testing may be completely normal in these cases. Muscle cramps may be persistent and are difficult to manage.

PMID 42456293
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PubMedArchives of endocrinology and metabolism2026-07-10

Rare types of congenital adrenal hyperplasia: report of five children with 11β-hydroxylase deficiency including pathogenic and novel CYP11B1 variants.

Bala Anju A, Banerjee Sayan S, George Arun A, Srivastava Priyanka P et al.

11β-hydroxylasedeficiency (11β-OHD) is a rare form of congenital adrenal hyperplasia caused by biallelic pathogenic variants in the CYP11B1 gene. It leads to impaired cortisol synthesis, resulting in increased adrenocorticotropic hormone stimulation and consequent accumulation of steroid precursors, which are diverted to androgen synthesis. In addition, the accumulation of 11-deoxycorticosterone, which is a potent mineralocorticoid, causes hyporeninemic hypokalemic hypertension. We report the clinical, hormonal, and genetic profiles of five children with 11β-OHD, emphasising phenotypic variability, a median 2-year diagnostic delay, the crucial role of hormonal profile in diagnosis, and management challenges, including post-treatment central precocious puberty. Two novel CYP11B1 variants were identified in two unrelated patients. Hydrocortisone replacement resolved hypertension in only one of the three hypertensive patients; others required spironolactone. Early differentiation of 11β-OHD from 21-hydroxylase deficiency is critical to prevent hypertension-related morbidity.

PMID 42429691
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PubMedBMJ open respiratory research2026-07-10

Low-dose corticosteroids in severe pulmonary infection: a meta-analysis of randomised controlled trials.

Lac Joanne J, Han Sooyeon S, Ahmad Mahmood M, Starey Harvey H et al.

Pulmonary infections are one of the leading causes of intensive care unit (ICU) admission and contribute to high mortality rates. This paper aimed to determine the effect of low-dose corticosteroids on outcomes in patients with severe pulmonary infections, including coronavirus disease of 2019, community-acquired pneumonia (CAP), pneumocystis pneumonia, sepsis, septic shock, and acute respiratory distress syndrome. We systematically reviewed randomised controlled trials (RCTs) comparing low-dose corticosteroids (≤400 mg hydrocortisone-equivalent daily) to placebo or standard care in adults with severe pulmonary infections. The primary outcome was short-term mortality (≤90 days). Secondary outcomes included 28-day mortality, 30-day mortality, number of patients with at least one serious adverse event, length of hospital stay and ICU stay. We analysed twelve RCTs including 4622 patients and 1203 events. The pooled OR showed a short-term mortality benefit: 0.83 (95% CI 0.70 to 0.98; p=0.029; I²=2.0%; number needed to treat: 37.84; Grading of Recommendations Assessment, Development and Evaluation (GRADE): low certainty). There was a reduction in length of ICU stay in patients with CAP, with a pooled mean difference of -0.78 days (95% CI -1.46 to -0.10, p=0.025). The use of corticosteroids did not significantly affect the length of hospital stay or severe adverse events. A significant difference remained in longer courses of steroids, whereas shorter courses had no significant difference (≤7 days vs >7 days; OR: 0.69; 95% CI 0.53 to 0.89; p=0.039 vs OR: 0.96; 95% CI 0.813 to 1.14; p=0.67; subgroup differences: p=0.03). Subgroup analyses in patients with CAP showed a significant benefit in short-term mortality (OR: 0.72, 95% CI 0.54 to 0.98; p=0.034; number needed to treat: 28.10). We found that low-dose corticosteroids significantly reduce 90-day mortality in severe CAP, although evidence for their benefit in other severe pulmonary infections and at shorter follow-up intervals remains inconclusive. CRD42024627881.

PMID 42425738
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PubMedFrontiers in pediatrics2026-07-09

Hydrocortisone for prevention or treatment of bronchopulmonary dysplasia: long-term neurodevelopmental safety and efficacy-a meta-analysis of randomized clinical trials.

Shehab Kawthar Ahmed KA, Almatrafi Rahaf Muslih N RMN, Ali Ethar E, Albargi Yara Y et al.

Postnatal systemic steroids can reduce inflammation that contributes to bronchopulmonary dysplasia (BPD) in extremely preterm infants; however, prior experience with dexamethasone raised concerns regarding long-term neurodevelopmental harm. As a result, hydrocortisone has been proposed as a potentially safer alternative. We conducted a meta-analysis of randomized controlled trials comparing hydrocortisone with placebo/routine care in preterm infants, stratified by early prophylaxis (<7 days) or late treatment (≥7 days). We searched major databases through February 2026. The primary outcome was the composite of death or neurodevelopmental impairment (NDI) at 2 years of corrected age. We included 17 studies representing seven distinct trials and their follow-up publications, comprising a total of 2,213 infants (1,096 receiving hydrocortisone and 1,117 receiving placebo). At 2 years, death/NDI occurred in 53.5% (531/993) of infants in the hydrocortisone group and 56.8% (581/1,023) of infants in the placebo group, with no significant effect observed with either early administration [risk ratio (RR) 0.89, 95% CI 0.70-1.13; I²=0%] or late administration (RR 0.97, 95% CI 0.80-1.17; I²=0%). Hydrocortisone was not associated with significant differences in death at 2 years (17.1% vs. 20.8%) or NDI at 2 years (42.5% vs. 43.9%) nor in cerebral palsy, hearing impairment, or visual impairment. Exploratory analyses showed no significant reduction in death or BPD at 36 week of postmenstrual age overall, and available school-age outcomes did not demonstrate differences in neurocognitive measures. Across randomized trials with long-term follow-up, postnatal hydrocortisone was not associated with improved survival free of NDI at 2 years nor was it associated with an increased risk of major neurodevelopmental or sensory impairments. These findings do not demonstrate an increased neurodevelopmental risk with hydrocortisone as used in current regimens, but its use should still be individualized based on respiratory phenotype, timing, and short-term monitoring for steroid-related adverse effects. PROSPERO CRD420261280132.

PMID 42422448
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PubMedEuropean journal of pediatrics2026-07-08

Hydrocortisone use in France: current practices in 2026.

Nuytten Alexandra A, Maallem Said S, Buttitta Marie M, Butin Marine M et al.

Over the past decade, new evidence has emerged regarding postnatal corticosteroids use in extremely preterm infants, particularly early prophylactic hydrocortisone. In France, national recommendations published in 2010 address late postnatal corticosteroids use only and do not incorporate the most evidence-based data. We aimed to provide a national overview of prescribing practices in French neonatal intensive care units (NICUs), focusing on prophylactic hydrocortisone. A national survey was conducted between 1 June and 13 August 2024 among all 66 French level III NICUs using a structured online questionnaire. One response per center was gathered. Fifty-five of 66 (83%) NICUs responded. Prophylactic hydrocortisone was used in 33 (60%) centers: 16 (29%) systematically and 17 (31%) selectively. Among users, 21 (64%) targeted the same population as the PREMILOC study. Non-users cited concerns about benefit-risk balance, lack of evidence, and absence of national guidelines. Fear of neurodevelopmental risk was more frequent among non-users (9/22 (41%) vs 1/33 (3%), p < 0.001), while perceived spontaneous intestinal perforation risk did not differ. Hydrocortisone use in French NICUs remain heterogeneous due to safety concerns and a possible uncertainty about the strength of evidence. These findings underscore the need for updated national guidelines to support harmonized, evidence-based care for ELGANs. • Recent evidence supports prophylactic hydrocortisone to improve survival without bronchopulmonary dysplasia in extremely preterm infants. • French national recommendations (2010) address late corticosteroid use (beyond 3 weeks) and do not incorporate recent evidence-based data. • This national survey provides the first overview of hydrocortisone use in French NICUs, highlighting heterogeneity in prescribing practices. • It identifies discrepancies between evidence and clinical practice, supporting the need for updated guidelines.

PMID 42418052
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