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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

PubMed[Rinsho ketsueki] The Japanese journal of clinical hematology2026-08-30

[Prolonged engraftment syndrome following autologous stem cell transplantation in Hodgkin lymphoma with prior immune checkpoint inhibitor therapy].

Kirito Keisuke K, Takeda Yusuke Y, Kimeda Chiharu C, Takakura Taiki T et al.

A 51-year-old woman with classical Hodgkin lymphoma refractory to multiple chemotherapy regimens, including an immune check inhibitor (ICI), was admitted to our hospital for autologous stem cell transplantation (auto-SCT). On day 7, she presented with a fever, skin rash, and elevated monocyte counts. We diagnosed engraftment syndrome (ES) and initiated corticosteroid therapy. Her symptoms resolved quickly, and we continued hydrocortisone until day 10. On day 11, she developed a fever, skin rash, and hypoxia, which we recognized as a relapse of ES. We started prednisolone at 0.5 mg/kg/day, leading to rapid symptom resolution of her symptoms, then we tapered the prednisolone on day 18. On day 19, she presented with hypotension and hypoxia, prompting us to increase the prednisolone dose to 1 mg/kg/day. Her symptoms resolved, and we gradually tapered the prednisolone dosage; she did not experience any further relapses of ES. Prior usage of ICIs has been reported to increase the risk of immune-related toxicity during allogeneic stem cell transplantation. Based on our experience, patients who have received ICIs before auto-SCT should also be closely monitored for immune-related toxicities in the early post-transplant period.

PMID 42669507
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PubMedArtificial organs2026-08-29

The Effects of Continuous Venovenous Hemofiltration on Immunosuppressive Drug concentrations in an Ex-Vivo Model of the critically Ill Adult: (CITRIC) study.

Chumas Lucy A LA, Wallis Steven C SC, Sumi Chandra C, Abdul-Aziz Mohd Hafiz MH et al.

The pharmacokinetics of immunosuppressive drugs during continuous kidney replacement therapy (CKRT) modalities such as continuous venovenous hemofiltration (CVVH) are poorly understood, yet these drugs are crucial for transplant and critically ill patients. An ex vivo adult CVVH circuit with AN69ST membrane was established, using whole blood (WB) or blood-crystalloid (BC) to simulate hypoproteinemia and anemia, across a range of ultrafiltration rates (UFR) (1000-4000 mL/h) and point-of-dilution. Study drugs (tacrolimus, ciclosporin, mycophenolic acid (MPA), hydrocortisone, and methylprednisolone) were administered at clinically relevant concentrations. Drug concentrations were quantified by ultra-high-performance liquid chromatography-tandem mass spectrometry, and sieving coefficient (Sc) and clearance (Cl) were calculated. Mean Sc and Cl were significantly higher for BC than WB: methylprednisolone (Sc: 0.44 vs. 0.19 p < 0.001; Cl: 17.31 mL/min vs. 6.99 mL/min p < 0.001), hydrocortisone (Sc: 0.20 vs. 0.09 p = 0.005; Cl: 7.12 mL/min vs. 3.15 mL/min p = 0.01), MPA (Sc: 0.05 vs. 0.02 p < 0.001; Cl: 1.83 mL/min vs. 0.71 mL/min p < 0.001), ciclosporin (Sc: 0.00 vs. 0.00 p = 0.008; Cl: 0.02 mL/min vs. 0.01 mL/min p = 0.004). Tacrolimus was undetectable in ultrafiltrate. Point-of-dilution had minimal effect, except at UFR 4000 mL/h where pre-dilution increased MPA and methylprednisolone clearance. Hydrocortisone and methylprednisolone were cleared by CVVH, while tacrolimus, ciclosporin, and MPA Cl were negligible or absent. Hypoproteinemia and anemia significantly increased drug Cl. These findings provide mechanistic insights and support the need for validation in clinical studies to guide dosing during CKRT.

PMID 42666083
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PubMedClinical case reports2026-08-29

Beyond the Rash: Simultaneous Bilateral Facial Nerve Palsy Following Childhood Varicella Infection.

Hassan Mohamed Sheikh MS, Ahmed Ibrahim Abdiwahid A, Mohamed Said Abdi SA, Sidow Nor Osman NO et al.

Bilateral facial nerve palsy is a rare neurological condition in children and is infrequently associated with primary Varicella (chickenpox) infection. We report the case of a 10-year-old previously healthy girl who developed simultaneous bilateral lower motor neuron facial weakness 3 weeks after a self-limiting varicella infection. The patient presented with acute onset inability to close both eyes, difficulty smiling, drooling of saliva, and impaired oral competence. At presentation, the characteristic vesicular rash had completely resolved. Neurological examination demonstrated bilateral lower motor neuron facial nerve palsy with loss of forehead creases, lagophthalmos, flattening of the nasolabial folds, inability to puff the cheeks, and bilateral Bell's phenomenon, without additional neurological deficits. Laboratory investigations and brain magnetic resonance imaging (MRI) were unremarkable. Based on the temporal relationship with recent varicella infection and exclusion of alternative etiologies, a diagnosis of bilateral facial nerve palsy secondary to varicella-zoster virus infection was established. The patient was treated with intravenous aciclovir, corticosteroids, supportive eye care, and facial physiotherapy. Follow-up after 6 weeks demonstrated marked clinical improvement, including restoration of facial symmetry, improved eye closure, recovery of smiling ability, and resolution of drooling. This case highlights a rare neurological complication of primary varicella infection and emphasizes the importance of early recognition and multidisciplinary management to achieve favorable neurological outcomes.

PMID 42666579
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PubMedPathogens (Basel, Switzerland)2026-08-27

Establishment of an HSV-1 Mouse Model with Cutaneous Lesions.

Ryu Hye-Myung HM, Riaz Bushra B, Sohn Seonghyang S

Herpes simplex virus type 1 (HSV-1) causes recurrent mucocutaneous lesions, yet existing animal models incompletely recapitulate characteristic skin manifestations. Here, we established a mouse model of cutaneous HSV-1 infection by combining epithelial barrier disruption with localized viral inoculation. Superficial scarification of the ear followed by HSV-1 exposure resulted in consistent lesion formation. Administration of hydrocortisone further increased the incidence of lesions, highlighting the critical roles of epithelial integrity and host immune regulation in the pathogenesis of HSV-1 infection. Using this model, we evaluated the antiviral efficacy of Acyclovir. Treatment significantly reduced lesion severity, lesion size, and viral gene expression, indicating partial suppression of viral replication. Notably, acyclovir treatment was associated with increased expression of T-bet and Foxp3 in lymphoid tissues, suggesting modulation of both effector and regulatory immune responses. Collectively, this model successfully reproduces localized HSV-1 skin lesions, serving as a useful platform for investigating viral pathogenesis and evaluating antiviral therapies. However, further studies, including direct viral quantification and histopathological analysis, are required.

PMID 42654725
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PubMedFrontiers in oncology2026-08-26

Case Report: Low-dose mitotane in a case of recurrent adrenocortical carcinoma: a 20-year clinical perspective.

Buczek Tomasz T, Kilar-Kobierzycka Ewa E, Halupczok-Żyła Jowita J, Bolanowski Marek M

Adrenocortical carcinoma (ACC) is a rare malignancy with a high risk of recurrence, and the prolonged use of mitotane is often limited by its narrow therapeutic window and endocrine and gastrointestinal toxicity. We describe a woman who presented at 42 years of age with a right adrenal mass in 2000. The tumour was macroscopically removed in 2001 and was diagnosed as a 7.4 × 5.6 × 6.0 cm, partially necrotic ACC with focal calcifications, invasion of the surrounding adipose tissue, and microscopically involved margins (pT3N0M0). A local recurrence was resected in 2006, after which mitotane was initiated at 6 g/day. Gastrointestinal intolerance required reduction to 3 g/day and subsequently to 1-2 g/day, with a temporary interruption in 2009. A contralateral adrenal lesion was removed in 2011 and proved to be an adenoma, resulting in bilateral adrenalectomy and lifelong glucocorticoid and mineralocorticoid replacement. Mitotane concentrations remained subtherapeutic for many years but reached 16.9 mg/L in 2021 and 20.3 mg/L in 2022 on 2 g/day. Mitotane was discontinued on 5 June 2025 after approximately 19 years of treatment. At the latest assessment, the patient remained in good general condition and continued hydrocortisone 40 mg/day, fludrocortisone 0.1 mg/day, and levothyroxine. Contrast-enhanced computed tomography on 28 May 2026 showed no local recurrence or metastatic disease. This case documents sustained disease control during and after almost 20 years of individualized mitotane therapy following recurrent ACC. It emphasizes the importance of dose adaptation, therapeutic drug monitoring, careful endocrine replacement, and cautious interpretation of long-term benefit in a single patient.

PMID 42643397
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PubMedClinical endocrinology2026-08-26

Serum Lipid Profile in Patients With Primary Adrenal Insufficiency Receiving Glucocorticoid Replacement.

Fichna Marta M, Fichna Piotr P, Sumińska Marta M, Gębarski Bolesław B et al.

Glucocorticoid (GC) replacement in Addison's disease (AD) usually fails to mimic physiological circadian cortisol rhythm. Recurrent hypercortisolemia may contribute to central obesity, hyperglycemia and dyslipidemia, which could explain cardiovascular mortality in AD. Steroid excess alters lipid profile, while effects of the replacement doses remain inconsistent, which led us to evaluate serum lipids in AD. A cross-sectional study in patients treated for autoimmune AD. The study comprised 66 patients diagnosed <1 year (AD1), 97 diagnosed >1 year (AD2) before the study and 96 matched controls (CON), excluding individuals with diabetes, thyroid dysfunction and lipid-lowering treatment. Investigations included physical examination and biochemical analyses. All patients were on immediate-release hydrocortisone (HC), mean ± SD 22.7 ± 6.6 mg/day. AD1 presented significantly lower HC dosage (p ≤ 0.001), higher TSH (p ≤ 0.046) and lower fasting glucose (p ≤ 0.005) versus AD2 and CON. Recently treated patients demonstrated significantly lower total cholesterol (TC), LDL-C and triglyceride (TG) levels versus both AD2 and CON, who displayed similar lipid profile. Only HDL-C was significantly higher in AD2 (p = 0.009). Hyperlipidemia was found in 62.5% CON subjects, 45.5% AD1 (p = 0.032), and 60.8% AD2 patients (p = 0.811). Age was strongly correlated with TC and LDL-C in AD and CON. Daily HC dose correlated with TC and LDL-C in both AD1 and AD2, and with HDL-C in AD1, and multivariable regression confirmed its predictive value with regard to TC and LDL-C. The risk of hyperlipidemia in patients receiving GC replacement does not seem elevated. Nonetheless, metabolic complications should be screened to improve long-term outcomes.

PMID 42644417
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