Newly synthesized tocainide analogs were tested for their state-dependent affinity and use-dependent behavior on sodium currents (I Na ) of adult skeletal muscle fibers by means of the Vaseline-gap voltage clamp method. The drugs had the pharmacophore amino group constrained in position ␣ [N-(2,6-dimethylphenyl)pyrrolidine-2-carboxamide (To5)] or  [N-(2,6-dimethylphenyl)pyrrolidine-3-carboxamide (To9)] in a prolinelike cycle and/or linked to a lipophilic benzyl moiety as in N-benzyl-tocainide (Benzyl-Toc), 1-benzyl-To5 (Benzyl-To5), and 1-benzyl-To9 (Benzyl-To9). I Na were elicited with pulses to Ϫ20 mV from different holding potentials (Ϫ140, Ϫ100, and Ϫ70 mV) and stimulation frequencies (2 and 10 Hz). All compounds were voltage-dependent and use-dependent channel blockers. The presence of a proline-like cycle increased the potency; i.e., To5 was 3-and 10-fold more effective than Toc in blocking I Na at the holding potential of Ϫ140 and Ϫ70 mV, respectively. The benzyl group on the amine further enhanced drug effectiveness with the following scale: Benzyl-To9 Ն Benzyl-Toc Ͼ Benzyl-To5. At a holding potential of Ϫ100 mV and 10-Hz stimulation, Benzyl-To9 blocked I Na with a half-maximal concentration of 0.5 M, being 60 and 400 times more potent than To9 and Toc, respectively. The similar effectiveness of Benzyl-Toc and Benzyl-To9 was paralleled by a similar spatial arrangement by equilibrium geometry modeling. In addition, the latter had a higher pK a value that probably contributed to a slow kinetic during its high use-dependent behavior. Benzyl-To5 had its lowest energy level at a more folded conformation that justifies the less favorable profile among the N-benzylated analogs. The new compounds are the most potent tocainide-like sodium channel blockers so far described and have high therapeutic potentials.The block of voltage-gated Na ϩ channel by local anestheticlike (LA) drugs has therapeutic value for numerous disorders characterized by abnormal membrane excitability (Clare et al., 2000). Different channel types show different sensitivities to LAs; however, the structural basis for this difference is still poorly understood (Wang et al., 1996;Li et al., 1999;2002). The selective activity on tissue displaying abnormal excitability pattern is based on the state-dependence of LA effect (i.e., a stronger potency at depolarized membrane potential or during high frequency trains of channel activity) (Catterall, 2002). This effect is related to drug interaction with a receptor whose affinity for ligands changes with the state-dependent transitions of the channel, the affinity being the highest when the channels open or inactivate. Mutagenesis studies identified various amino acid residues, localized in the S6 segments of each homologous domain of the ␣ subunit, as critical for LA binding and activity on Na ϩ channels of various excitable tissues (Ragsdale et al., 1994(Ragsdale et al., , 1996Wright et al., 1998;Li et al., 1999;Nau et al., 1999;Wang et al., 2000;Yarov-Yarovoy et al., 2001, 2002. LAs may int...