Voltage-gated na + (na V) channels regulate homeostasis in bacteria and control membrane electrical excitability in mammals. Compared to their mammalian counterparts, bacterial Na V channels possess a simpler, fourfold symmetric structure and have facilitated studies of the structural basis of channel gating. However, the pharmacology of bacterial Na V remains largely unexplored. Here we systematically screened 39 Na V modulators on a bacterial channel (NaChBac) and characterized a selection of compounds on NaChBac and a mammalian channel (human Na V 1.7). We found that while many compounds interact with both channels, they exhibit distinct functional effects. For example, the local anesthetics ambroxol and lidocaine block both Na V 1.7 and NaChBac but affect activation and inactivation of the two channels to different extents. The voltage-sensing domain targeting toxin BDS-i increases na V 1.7 but decreases NaChBac peak currents. The pore binding toxins aconitine and veratridine block peak currents of Na V 1.7 and shift activation (aconitine) and inactivation (veratridine) respectively. In NaChBac, they block the peak current by binding to the pore residue F224. Nonetheless, aconitine has no effect on activation or inactivation, while veratridine only modulates activation of NaChBac. The conservation and divergence in the pharmacology of bacterial and mammalian na V channels provide insights into the molecular basis of channel gating and will facilitate organism-specific drug discovery. Electrical signaling is a highly conserved biological mechanism throughout the evolution of plants and animals 1,2. From prokaryotic organelles to vertebrates, ion channels are key regulators of cellular homeostasis, electrolyte balance and signaling 1. Single-celled eukaryotes first evolved voltage-gated calcium channels (Ca V), which are believed to have evolved subsequently into voltage-gated Na + (Na v) channels predating the origin of nervous systems in animals 3. In prokaryotes, Na V channels might have evolved independently to regulate cellular homeostasis, though their exact functions are not well understood. In humans, the malfunction of Na V channels, either through genetic mutations or off-target drug interactions, results in severe pathologies including cardiac arrhythmia and epilepsy 4. Given their critical physiological function, pathological relevance and utility as therapeutic targets, it is essential to understand the interaction of Na V channels with pharmacological agents. This task has been facilitated by the recent determination of prokaryotic 5-7 and eukaryotic 8-13 Na V channel structures. However, these structures do not provide a clear picture of the dynamic conformational changes that underlie state and voltage-dependent effects of pharmacological agents. Therefore, functional studies must be integrated with structural insights to elucidate the molecular mechanisms of compound-channel interaction 14,15. Eukaryotic Na V channels are large, complex membrane-bound proteins composed of four homologous domain...