To investigate the mechanisms of Na+ loading during metabolic inhibition (MI), [Na+]i and pHi were measured in quiescent guinea pig myocytes using fluorescent probes, sodium-binding benzofuran isophthalate and 2,7,bis(carboxyethyl)-5,6-carboxyfluorescein. When myocytes were exposed to MI (3.3 mM amobarbital and 5 microM carbonyl cyanide m-chlorophenylhydrazone, without glucose) for 20 min, [Na+]i increased from 8.3 +/- 0.7 mM to 17.7 +/- 1.3 mM (p < 0.01) and pHi decreased from 7.22 +/- 0.03 to 7.00 +/- 0.04 (p < 0.05). The inhibition of Na(+)-H+ exchange by hexamethylene amiloride (HMA) significantly attenuated the increase in [Na+]i during MI (9.3 +/- 0.9 mM; p < 0.01 vs MI without HMA). When a K(+)-free solution was perfused to inhibit the Na+/K+ pump in the presence of HMA, there was an immediate increase in [Na+]i during MI. Perfusion of a K(+)-free solution after 10 min of MI caused no change in the rate of the increase in [Na+]i. We concluded that 1) Na+/H+ exchange was an important mechanism for Na+ elevation during MI, and 2) the Na+/K+ pump was functional during the early phase of MI, but was inhibited 10 min after MI in this model.