The disposition of piroxicam in 23 patients with rheumatoid arthritis (9 males, 14 females, aged 27-79) was studied over 6 weeks using the standard oral dose of 20 mg daily. Clinical status was monitored using standard methods. The mean piroxicam steady state plasma concentration (Css) averaged 9.2 +/- 4.4 micrograms/ml, the majority of which was highly protein bound (1.4 +/- 0.5% unbound). Total plasma clearance (CL/F) of piroxicam was 1.85 +/- 0.81 ml/min and the half life (t1/2) was 53.0 +/- 24.2 h. There was wide intersubject variability in the kinetics of piroxicam and its major metabolite 5'-hydroxypiroxicam. Piroxicam CL/F, t1/2 and Css were modestly correlated with patient age. Clinical effects did not appear to be related to piroxicam plasma levels.