The organic anion transporting polypeptides, Oatp1 (Slc21a1) and Oatp2 (Slc21a5), mediate hepatic uptake of cardiac glycosides. Previously, we demonstrated that chemicals that increase cytochrome P450s differentially affect hepatic uptake of cardiac glycosides. We postulated that increased uptake of cardiac glycosides observed after pretreatment of animals with phenobarbital (PB) and pregnenolone-16␣-carbonitrile ( Hepatic clearance and biliary excretion of drugs and their metabolites can occur through passive transport or through active transport (carrier-mediated) systems. Previous studies from this laboratory described a phenomenon in which pretreatment of animals with chemicals known to differentially increase specific microsomal cytochrome P450 enzymes also enhanced both hepatic plasma clearance and biliary excretion of a number of choleophiles, including cardiac glycosides. [1][2][3][4] Specifically, pretreatment of rats with two compounds known classically to activate CYP2B and CYP3A transcription, the barbiturate phenobarbital (PB) and the synthetic steroid pregenenolone-16␣-carbonitrile (PCN), respectively, resulted in the decreased plasma half-life, increased hepatic clearance, and decreased toxicity of cardiac glycosides. In contrast, pretreatment of rats with chemicals known to act through the aryl hydrocarbon receptor resulted in a slight suppression of cardiac glycoside plasma clearance by the liver. 2 Further studies demonstrated that PCN increased the maximal velocity and affinity of ouabain uptake into hepatocytes, 3 suggesting that this chemical altered the hepatocellular capacity and affinity for choleophilic substrates. In subsequent studies, an energydependent, Na ϩ -independent carrier-mediated transport system for ouabain was identified. This Na ϩ -independent transport system was sensitive to inhibition by neutral (e.g., digoxin), acidic (e.g., taurocholate), and basic (e.g., quinine) compounds. 4 Together, these findings suggested that a multispecific, Na ϩ -independent hepatic transport system existed, which could be positively modulated by microsomal enzymeinducing chemicals, specifically PB and PCN.Since these earlier reports, 1-4 specific mediators of this hepatic Na ϩ -independent transport system have been cloned and characterized, and consist of several members of the rat organic anion transporting polypeptide (Oatp) family. The primary forms expressed in rat liver include, Oatp1 (gene symbol: Slc21a1), Oatp2 (Slc21a5), and liver-specific transporter 1 (rlst-1) or Oatp4 (Slc21a10). In rat liver, the organic anion transporting polypeptides, Oatp1, 5 Oatp2, 6,7 and rlst-1/ Oatp4, 8-10 transport a number of conjugated and unconjugated xenobiotics and endobiotics in a charge-independent manner. The substrates for this family of transporters include: the cardiac glycosides, the statin class of lipid-lowering drugs, human immunodeficiency virus-protease inhibitors, bile acids, eicosanoids, thyroid hormone and thyroid hormone conjugates, steroid hormone conjugates, and numerous peptidede...