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Acyclovir and Hydrocortisone

Medically reviewed by Last updated on April 14, 2020.


(ay SYE kloe veer & hye droe KOR ti sone)

Index Terms

  • Acyclovir/Hydrocortisone
  • Hydrocortisone and Acyclovir
  • ME-609
  • Xerclear

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Cream, External:

Xerese: Acyclovir 5% and hydrocortisone 1% (5 g) [contains cetostearyl alcohol, propylene glycol]

Brand Names: U.S.

  • Xerese

Pharmacologic Category

  • Antiviral Agent, Topical
  • Corticosteroid, Topical


Acyclovir: Acyclovir is converted to acyclovir monophosphate by virus-specific thymidine kinase then further converted to acyclovir triphosphate by other cellular enzymes. Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA.

Hydrocortisone: Topical corticosteroids have anti-inflammatory, antipruritic, and vasoconstrictive properties.

Use: Labeled Indications

Herpes labialis: Treatment of recurrent herpes labialis (cold sores) in children ≥6 years and adults.


There are no contraindications listed in the manufacturer's US labeling.

Canadian labeling: Additional contraindications not in US labeling: Known or suspected history of hypersensitivity to acyclovir, valacyclovir, hydrocortisone, or any component of the formulation; untreated infections of bacterial, viral, tuberculous, or fungal origin.

Dosing: Adult

Herpes labialis (cold sores): Topical: Apply 5 times/day for 5 days

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Herpes labialis (cold sores): Children ≥6 years and Adolescents: Topical: Apply 5 times daily for 5 days; initiate therapy at first sign of infection (ie, during the prodrome or when lesions appear)

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.


For external use only; not for use in the eye, inside the mouth or nose, or on the genitals. Wash hands before and after application. Use sufficient amount to cover the affected area(s), including the outer margin of cold sore; do not rub affected area. Initiate therapy early (ie, during the prodrome or when lesions appear).


Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F); do not freeze.

Drug Interactions

Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination

Calcipotriene: Hydrocortisone (Topical) may diminish the therapeutic effect of Calcipotriene. Management: Monitor for reduced calcipotriene efficacy if combined with hydrocortisone valerate. Consider separating the administration of these agents by 10 to 12 hours to minimize the risk of this potential interaction. Monitor therapy

Talimogene Laherparepvec: Antiherpetic Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec. Monitor therapy

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

<1%, postmarketing, and/or case reports: Allergic contact sensitivity, application site reaction, burning sensation of skin, contact dermatitis (when applied under occlusion), dyschromia, erythema, exfoliation of skin, tingling of skin, xeroderma


Concerns related to adverse effects:

• Sensitization: Use has been associated with local sensitization (irritation).

Disease-related concerns:

• Herpes labialis: Appropriate use: Treatment should begin with the first signs or symptoms. For external use only to the lips and around the mouth; do not apply to eye, inside the mouth or nose, or on the genitals. Contact healthcare provider if cold sore does not heal in 2 weeks.

Special populations:

• Immunocompromised patients: Use with caution in immunocompromised patients.

Pregnancy Considerations

Systemic exposure of acyclovir and hydrocortisone after topical administration is minimal.

Refer to individual monographs for additional information.

Patient Education

What is this drug used for?

• It is used to treat cold sores.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dry skin

• Burning

• Skin tingling

• Skin discoloration

• Skin irritation

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.