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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

PubMedKidney international reports2026-07-25

Hydrocortisone Use for Septic Shock in Patients With CKD.

Dhamelia Parth P, Abeyagunawardene Hashane H, Kore Rajshekhar A RA, Raghavan Deepa D et al.

Patients with chronic kidney disease (CKD) are at higher risk of septic shock and mortality than the general population. Although hydrocortisone is often used as an adjuvant therapy for septic shock in the general population to improve clinical outcomes, its effectiveness in patients with CKD remains understudied. We identified a retrospective cohort of patients within TriNetX US collaborative database diagnosed with nondialysis CKD between November 1, 2010 and October 31, 2025 who also developed septic shock. Outcomes of interest within 90 days included all-cause mortality, major adverse kidney events (MAKE) without persistent kidney dysfunction, major adverse cardiovascular or cerebrovascular events (MACCE), mechanical ventilation, hyperglycemia, reinfections, and delirium. Survival analyses and multivariable Cox proportional hazard models were performed. One to 1, we propensity-score matched 13,141 CKD patients with sepsis treated with hydrocortisone with 13,141 CKD patients with sepsis not treated with hydrocortisone. Our cohort had a mean age of 70 ± 12 years and was 46% female, 21% African American, and 5% Hispanic. Most patients had hypertension (95%), were diabetic (63%), and had ischemic heart disease (68%). Mean serum creatinine concentration was 2.3 ± 2.7 mg/dl, mean lactate concentration was 3 mmol/l, and 25% of patients required mechanical ventilation. In this propensity-score matched analysis, more patients died in the group given hydrocortisone than in the group not given hydrocortisone (4263 [32.4%] vs. 3654 [27.8%]) with adjusted hazard ratio (HR) 1.31 (95% confidence interval [CI]: 1.25-1.36). Hydrocortisone group had higher risk of MAKE HR 1.08 (95% CI: 1.05-1.12), MACCE HR 1.19 (95% CI: 1.15-1.24), and mechanical ventilation HR 1.34 (95% CI: 1.27-1.41) but lower reinfections HR 0.88 (95% CI: 0.85-0.91) and no differences in hyperglycemia HR 1.04 (95% CI: 1.00-1.07) and delirium HR 1.07 (95% CI: 1.00-1.14). In this large, national, multicenter retrospective cohort of patients with CKD and septic shock, use of hydrocortisone was associated with increased risk of mortality, cardiorenal, and pulmonary outcomes, but reduced risk of reinfections. These findings warrant more research to rigorously evaluate the effects of hydrocortisone use in septic shock for this high-risk population.

PMID 42500310
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PubMedFrontiers in immunology2026-07-25

The cell-mediated adaptive immune response to herpes simplex virus type 1 encephalitis: mechanisms and clinical implications.

Osborne Louise L, Dunai Cordelia C, Huang Yun Y, Egbe Franklyn N FN et al.

Herpes simplex virus (HSV) encephalitis is the most frequent cause of sporadic encephalitis globally. Despite the emergence of the antiviral drug aciclovir curtailing mortality, this disease remains a clinical challenge due to its rapid progression and associated neurological sequelae; indicating the urgent requirement for adjunctive neuroprotective treatment options. Recent studies using both human samples and murine models have highlighted how cell mediated immune cells including CD8+, CD4+ and brain tissue-resident memory T cells have the capacity to act as a 'double-edged sword'; both serving to protect the host against HSV encephalitis, but also increasing neuroglial injury by inflammation. Factors which impair cell-mediated immunity may predispose individuals to herpes simplex encephalitis, including defects in viral immune evasion strategies (infected cell protein 47, UL13 kinase), host genetic pre-disposition (toll-like receptor 3 deficiency, lymphotoxin-α deficiency, Rel mutations) and external factors such as stress. Additionally, there is a particular need for clinical vigilance for patients on immunosuppressive treatments which impair cell-mediated immunity, including azathioprine, hydroxychloroquine and methotrexate. Conversely, understanding these molecular mechanisms may provide new insights into the use of immunomodulatory strategies including anakinra, tocilizumab, and the implementation of targeted vaccination. This review summarises the current state of knowledge of how an impaired cell-mediated immune response could promote herpes simplex virus encephalitis, followed by an exploration of the clinical applications and therapeutic interventions which could viably be implemented to ameliorate immune-mediated tissue injury.

PMID 42500662
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PubMedBiomaterials research2026-07-25

Tryptanthrin Nanoliposomal Lotion as a Corticosteroid-Free Strategy for Safe and Effective Treatment of Atopic Dermatitis.

Song Yo Han YH, Na Young-Guk YG, Yoon Moon Sup MS, Kim Da-Eun DE et al.

Atopic dermatitis is a chronic inflammatory skin disease characterized by dry skin, itching, and recurrent eczematous lesions. Although current therapeutic strategies are effective, their use is often limited due to adverse effects. Therefore, the development of safer and more effective alternatives is required. Tryptanthrin is a yellow-gold alkaloid compound with anti-atopic and various pharmacological activities. However, its poor aqueous solubility results in low topical bioavailability. A tryptanthrin-loaded liposomal lotion was developed using a design of experiments approach to improve topical delivery. The optimized formulation showed enhanced physicochemical stability and moisturizing properties, as well as improved drug release compared to free tryptanthrin. In human keratinocyte cells, the liposomal lotion exhibited lower cytotoxicity than the free tryptanthrin and demonstrated higher skin residual. In the DNCB-induced atopic dermatitis mouse model, the tryptanthrin-loaded liposomal lotion produced therapeutic effects comparable to or greater than those of 1.0% hydrocortisone, without inducing adverse effects such as skin atrophy. Overall, the tryptanthrin-loaded liposomal lotion is presented as a promising and safe strategy for the topical treatment of atopic dermatitis.

PMID 42499629
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PubMedCureus2026-07-24

Tofacitinib as Rescue Therapy in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Cohort Study with Observations on Cytomegalovirus Coinfection.

Banerjee Subhadeep S, Yadav Dawesh D, Gupta Anand A, Kumar Ujjwal U et al.

Acute severe ulcerative colitis (ASUC) is a severe and potentially life-threatening condition in which one-third of patients are refractory to intravenous corticosteroids. Established rescue therapies--infliximab and cyclosporine--are limited by cost, administration constraints, and toxicity. Tofacitinib, an oral Janus kinase (JAK) inhibitor, possesses pharmacokinetic and mechanistic properties that may be advantageous in the inpatient setting. This study was conducted to assess the short-term efficacy and safety of tofacitinib as rescue therapy in steroid-refractory ASUC and to identify clinical predictors of treatment failure. We conducted a retrospective cohort analysis of all patients with ASUC admitted to our tertiary gastroenterology unit between March 2023 and August 2025. ASUC was defined per Truelove and Witts' criteria. Patients who failed to respond to intravenous hydrocortisone by Day 3 and who could not receive infliximab (due to cost or contraindication) were initiated on tofacitinib (10 mg thrice daily for 3 days, followed by 10 mg twice daily). The primary outcome was clinical response by Day 5-7, defined as a reduction in Mayo score of ≥3 points (≥30% from baseline) with an absolute rectal bleeding sub-score of 0-1. Secondary outcomes included non-response rate, adverse events, and the impact of colonic cytomegalovirus (CMV) DNA burden on treatment response. Ten consecutive patients with steroid-refractory ASUC received tofacitinib rescue therapy. The mean age was 29.6 ± 9.1 years; 60% were male. Seven patients (70%) achieved clinical response within 5-7 days. Three patients (30%) failed to respond and required alternative rescue therapy or surgical consultation. CMV DNA was detected in the colonic tissue of four patients; both patients with high viral loads (>50,000 copies/mL) failed to respond to tofacitinib despite concurrent antiviral therapy. Adverse events were minimal; one patient developed bicytopenia of uncertain attribution. Tofacitinib demonstrated a 70% short-term clinical response rate in steroid-refractory ASUC, with an acceptable safety profile. Higher colonic CMV DNA appeared to be associated with a lower likelihood of clinical response; however, this observation requires validation with further research. Tofacitinib represents a viable, cost-effective rescue option, particularly in resource-limited settings or when conventional biologics are contraindicated. Prospective comparative studies are needed to define its optimal positioning within ASUC treatment algorithms.

PMID 42495474
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PubMedHospital pharmacy2026-07-23

Impact of Peripheral Rabbit Anti-Thymocyte Globulin Without Heparin and Hydrocortisone Additives on Local Infusion Reactions.

Borges Leanna L, Conrath Meagan M, O'Sullivan David M DM, Marti Kristen K

Rabbit anti-thymocyte globulin (rATG) is indicated for induction immunosuppression therapy in renal transplant recipients. Heparin and hydrocortisone are standardly added to peripheral rATG preparations to reduce the incidence of local infusion reactions. In March 2023, this institution removed heparin and hydrocortisone additives in peripheral rATG preparations to avoid medication waste in the setting of drug shortages. The purpose of this study was to compare the incidence of local infusion reactions in renal transplant recipients receiving peripheral rATG with and without additives. This was a single-center, retrospective, pre- and post-implementation cohort study of adult renal transplant recipients. Patients were included if they were ≥18 years of age, received rATG through a peripheral line, and received a renal transplant between November 1, 2022 and July 12, 2023, inclusive. The primary outcome was the incidence of local infusion reactions. Descriptive statistics were used to report baseline demographics and a Fisher's exact test was used to compare rates of local infusion reactions in the additives and no additives groups. A total of 261 peripheral rATG doses were included in the analysis. The baseline characteristics were similar between the two groups. Of the 261 rATG infusions, 120 infusions included heparin and hydrocortisone in the preparation, while 141 of the infusions did not contain additives. The difference between groups in occurrence of local infusion reactions was not statistically significant. Local infusion reactions were reported during ten (8.3%) rATG infusions with additives compared to eight (5.7%) rATG infusions without additives (P = .398). Renal transplant recipients receiving rATG induction therapy without heparin and hydrocortisone additives via peripheral infusion had a similar incidence of local infusion reactions compared to those with additives. Additional studies are needed to substantiate these findings.

PMID 42491035
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PubMedBiological trace element research2026-07-23

Health and Regulatory Assessment of Hydroquinone, Mercury and Steroids in Skin-Lightening Creams Marketed in Pakistan.

Shujait Mahnoor M, Nawaz Ch M M, Hussain Naqi N

People from all over the world use cosmetics to enhance their physical appearance, seeking social acceptance. Most locally produced skin-lightening creams used in developing countries are a mixture of fat and water applied to the skin surface. These Skin Lightening creams may pose a potential health risk due to their inclusion of various highly toxic active ingredients like hydroquinone, mercury, and steroids. This study quantifies the levels of these toxic substances in ten commonly used SLC brands in Pakistan and their associated health risks in samples marketed in Lahore. To determine the concentration levels of various ingredients, including hydroquinone, steroids (Betamethasone, Dexamethasone, Hydrocortisone, and Prednisolone), and mercury, high-performance liquid chromatography, ultra violet- high-performance liquid chromatography, and a direct mercury analyzer were used, respectively. Health risks were assessed by calculating Chronic Daily Intake (CDI) and Hazard Quotient (HQ). Results showed that some samples exceeded international limits for hydroquinone (up to 5.56%) and mercury (up to 4.9 ppm), surpassing U.S Food and Drug Administration (USFDA), Pakistan Standards and Quality Control Authority (PSQCA), and World Health Organization (WHO) standards. The analysis also revealed undeclared corticosteroids in several samples: betamethasone (0.6-1.8% in 30% of samples), dexamethasone (1.4-6.4% in 20% of samples), hydrocortisone (0.4-8.5% in 50% of samples), and prednisolone (0.3-1.6% in 30% of samples). These findings suggest the need for improved regulatory enforcement in developing countries along with enhanced monitoring of Pakistan's cosmetic industry to effectively protect public health from the cumulative toxicity of hydroquinone, mercury, and corticosteroids.

PMID 42487054
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