Abstract-Dipeptide esters of paracetamol were prepared in high yields. These compounds are quantitatively hydrolyzed to paracetamol and corresponding 2,5-diketopiperazines at pH 7.4 and 37°C. The reactivity is increased in sarcosine and proline peptides and decreased by bulky side chains at both the N-and C-terminal residues of the dipeptide carrier. Moreover, dipeptide esters of paracetamol did not affect the levels of hepatic glutathione. Thus, dipeptides seem promising candidates as carriers for cyclizationactivated prodrugs. Ó 2005 Elsevier Ltd. All rights reserved.Phenol drugs are attractive targets for prodrug design due to their extensive first-pass metabolism. 1 In the case of paracetamol, 1 (Scheme 1), the metabolism can lead to serious hepatic and renal toxic effects. 2 These toxic side-effects have been ascribed to the formation of a N-acetylquinone imine, 3 which is detoxified by reaction with glutathione leading to glutathione depletion and cell death. 3,4 Esterification of paracetamol with amino acids was reported as a means to obviate the severe hepatotoxicity of the drug at high doses 5 as well as to increase aqueous solubility. 6 We now report that dipeptides may also be used as carriers for hydroxyl-containing drugs. Dipeptide esters and amides (2, X = O or NH, Scheme 1) can deliver the parent drug through enzyme-independent processes such as the intramolecular cyclization to form the corresponding diketopiperazines (3, DKPs, Scheme 1). 7,8 The major drawback of using dipeptides as carrier candidates for prodrugs is their susceptibility to non-specific peptidases. However, enzymatically stable dipeptides (e.g., containing 2-aminoisobutyric acid or N-methylglycine as carriers) have been used successfully to improve physico-chemical properties of cytarabine 9 and cyclosporine. 10 Despite the potential of dipeptides as carriers for cyclization-activated prodrugs, there is a lack of systematic information concerning the effect of the peptide structure on the rate of drug release under physiological conditions. Herein we report the synthesis and the chemical reactivity of dipeptide esters of paracetamol, 4, encompassing a wide range of amino acid residues to evaluate the suitability of dipeptide esters as potential cyclization-activated prodrugs of paracetamol. In addition, the potential hepatotoxicity of several paracetamol derivatives was studied by evaluating the effect on the hepatic levels of glutathione in mice.Paracetamol esterification was based on the O-(benzotriazol-1-yl)-N,N,N 0 ,N 0 -tetramethyluronium 0960-894X/$ -see front matter Ó