Dipyridamole-mediated inhibition of nucleoside transport by the nitrobenzylthioinosine (NBMPR)-sensitive facilitated diffusion system in mammalian erythrocytes was investigated. [3H]Dipyridamole was a competitive inhibitor of uridine equilibrium exchange influx into guinea pig erythrocytes (apparent Ki 1 nM). Analysis of the results using total inhibitor levels instead of cell-free inhibitor concentrations increased the apparent Ki value to 7 nM. Similarly, [3H]dipyridamole inhibition of zero-trans-[14C] uridine influx was consistent with simple competitive inhibition (apparent Ki 1.4 +/- 0.7 nM). In contrast, [3H]dipyridamole behaved as a noncompetitive inhibitor of zero-trans-[14C]uridine efflux (apparent Ki 0.7 +/- 0.2 nM). In a second series of experiments, [3H]dipyridamole was found to bind to a single class of high affinity sites on plasma membranes from human erythrocytes (apparent Kd 0.65 +/- 0.07 nM) with a maximum number of binding sites similar to that determined with the nucleoside transport inhibitor NBMPR. Binding of dipyridamole to these sites was blocked by the nucleoside transport inhibitors NBMPR, nitrobenzylthioguanosine, and dilazep and in a competitive manner by adenosine and uridine (apparent inhibition constants 0.1 and 0.9 mM, respectively). These inhibition constants are similar to the apparent Km for adenosine and uridine equilibrium exchange in human erythrocytes. These results are consistent with the notion that, in mammalian erythrocytes, dipyridamole interacts with the NBMPR-sensitive transporter at the same site as NBMPR, which is preferentially located on the outer surface of the cell membrane totally or partially within the permeation site.