Tyrosine 401 of the skeletal muscle isoform (0`1) of the rat muscle Na channel is an important determinant of high affinity block by tetrodotoxin (TTX) and saxitoxin (STX) in Na-channel isoforms. In mammalian heart Na channels, this residue is substituted by cysteine, which results in low affinity for TTX/STX and enhanced sensitivity to block by Zn ~+ and Cd 2+. In this study, we investigated the molecular basis for high affinity block of Na channels by STX and divalent cations by measuring inhibition of macroscopic Na § current for a series of point mutations at residue Tyr401 of the rat 0`1 Na channel expressed in Xen0-pus oocytes. Substitution of Tyr401 by Gly, Ala, Ser, Cys, Asp, His, Trp, and Phe produced functional Na § currents without major perturbation of gating or ionic selectivity. High affinity block by STX and neosaxitoxin (NEO) with/~ values in the range of 2.6-18 nM required Tyr, Phe, or Trp, suggestive of an interaction between an aromatic ring and a guanidinium group of the toxin. The Cys mutation resulted in a 7-and 23-fold enhancement of the dissociation rate of STX and NEO, respectively, corresponding to rapid toxin dissociation rates of cardiac Na channels. High affinity block by Zn 2+ (/~ = 8-23 0`M) required Cys, His, or Asp, three residues commonly found to coordinate direcdy with Zn 2+ in metalloproteins. For the Cys mutant of 0.1 and also for the cardiac isoform Na channel (rhl) expressed in the L6 rat muscle cell line, inhibition of macroscopic Na § conductance by Zn ~ § reached a plateau at 85-90% inhibition, suggesting the presence of a substate current. The ASp mutant also displayed enhanced affinity for inhibition of conductance by Ca 2+ (/~ = 0.3 mM vs ~40 mM in wild type), but block by Ca ~ § was incomplete, saturating at ~69% inhibition. In contrast, Cd 2 § completely blocked macroscopic current in the Cys mutant and the L6 cell line. These results imply that the magnitude of substate current depends on the particular residue at