Oxicam is a class of non-steroidal anti-inflammatory drugs (NSAIDs),[2] meaning that they have anti-inflammatory, analgesic, and antipyretic therapeutic effects. Oxicams bind closely to plasma proteins.[1] Most oxicams are unselective inhibitors of the cyclooxygenase (COX) enzymes. The exception is meloxicam with a slight (10:1) preference for COX-2, which, however, is only clinically relevant at low doses.[3]
The most popular drug of the oxicam class is piroxicam.[1] Other examples include: ampiroxicam, droxicam, pivoxicam, tenoxicam, lornoxicam,[1] and meloxicam.
Isoxicam has been suspended as a result of fatal skin reactions.[1]
The physico-chemical characteristics of these molecules vary greatly depending upon the environment.[4]
In contrast to most other NSAIDs, oxicams are not carboxylic acids. They are tautomeric, and can exist as a number of tautomers (keto-enol tautomerism), here exemplified by piroxicam:[2]
The oxicams are associated with drug-related erythema multiforme (EM), Stevens–Johnson syndrome, and toxic epidermal necrolysis (TEN). This association is one of the reasons oxicams are not regularly prescribed.
pyrazolones / pyrazolidines | |
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salicylates | |
acetic acid derivatives and related substances | |
oxicams |
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propionic acid derivatives (profens) |
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n-arylanthranilic acids (fenamates) | |
COX-2 inhibitors (coxibs) | |
other | |
NSAID combinations | |
Key: underline indicates initially developed first-in-class compound of specific group; #WHO-Essential Medicines; †withdrawn drugs; ‡veterinary use. | |
Receptor (ligands) |
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Enzyme (inhibitors) | |||||||||||||||||
Others | |||||||||||||||||