Oxicam is a class of nonsteroidal anti-inflammatory drugs (NSAIDs) that 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 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:
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.