oxicams

Oxicams are a class of non-steroidal anti-inflammatory drugs (NSAIDs) used to treat pain and inflammation in conditions such as osteoarthritis and rheumatoid arthritis. The oxicam family is notable for long duration of action and long half-lives, which allow convenient once-daily dosing in many regimens.

Common representatives include piroxicam, meloxicam, and tenoxicam; lornoxicam is also described as an oxicam in some sources. Mechanistically, oxicams inhibit cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis and producing analgesic, anti-inflammatory, and antipyretic effects. Meloxicam tends to be relatively more COX-2–selective at standard doses, a profile that may contribute to a somewhat improved gastrointestinal safety margin compared with non-selective NSAIDs.

Indications include management of pain and inflammation in osteoarthritis and rheumatoid arthritis; they may also be used for other painful conditions and, in some cases, dysmenorrhea or short-term analgesia. Pharmacokinetically, oxicams are administered orally (and in some cases by other routes), absorbed with extensive tissue distribution, metabolized in the liver, and excreted by renal and biliary pathways.

Safety and contraindications mirror other NSAIDs: they can cause gastrointestinal irritation, ulcers, and bleeding; they may impair renal function and cause fluid retention, hypertension, and edema; and they carry cardiovascular risk with long-term use. They are contraindicated in active peptic ulcer disease, significant renal or hepatic impairment, and in late-stage pregnancy, among other NSAID hypersensitivities. Cautions include use in the elderly and with concomitant NSAID or anticoagulant therapy.