A very potent and specific inhibitor of mitochondrial NADH:ubiquinone oxidoreductase (complex I), a derivative of NADH (NADH-OH) has recently been discovered (Kotlyar, A. B., Karliner, J. S., and Cecchini, G. (2005) FEBS Lett. 579, 4861-4866). Here we present a quantitative analysis of the interaction of NADH-OH and other nucleotides with oxidized and reduced complex I in tightly coupled submitochondrial particles. Both the rate of the NADH-OH binding and its affinity to complex I are strongly decreased in the presence of succinate. The effect of succinate is completely reversed by rotenone, antimycin A, and uncoupler. The relative affinity of ADPribose, a competitive inhibitor of NADH oxidation, is also shown to be significantly affected by enzyme reduction (K D of 30 and 500 μM for oxidized and the succinate-reduced enzyme, respectively). Binding of NADH-OH is shown to abolish the succinate-supported superoxide generation by complex I. Gradual inhibition of the rotenone-sensitive uncoupled NADH oxidase and the reverse electron transfer activities by NADH-OH yield the same final titration point (~0.1 nmol/mg of protein). The titration of NADH oxidase appears as a straight line, whereas the titration of the reverse reaction appears as a convex curve. Possible models to explain the different titration patterns for the forward and reverse reactions are briefly discussed.The mitochondrial proton-translocating NADH:ubiquinone oxidoreductase (complex I) and its prokaryotic homologues (NDH-1) 1 catalyze oxidation of NADH coupled to reduction of the membrane-located quinone. In aerobic organisms the enzymes provide at least two vitally important functions. First, they reoxidize NADH produced by multiple dehydrogenases, thus maintaining and controlling general oxidative metabolism. Second,