title: Oxicam
text: # Oxicam
  
  Oxicam is a class of non-steroidal anti-inflammatory drugs (NSAIDs), meaning that they have anti-inflammatory, analgesic, and antipyretic therapeutic effects. Oxicams bind closely to plasma proteins. 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.
  
  The most popular drug of the oxicam class is piroxicam. Other examples include: ampiroxicam, droxicam, pivoxicam, tenoxicam, lornoxicam, and meloxicam.
  
  Isoxicam has been suspended as a result of fatal skin reactions.
  
  ## Chemistry
  
  The physico-chemical characteristics of these molecules vary greatly depending upon the environment.
  
  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:
  
  ## Side effects
  
  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.
  
  