What is the primary enzyme involved in the first step of cocaine metabolism?

The primary enzyme involved in the first step of cocaine metabolism is carboxyl esterase. This enzyme plays a crucial role in the hydrolysis of cocaine into its primary metabolites, namely benzoylecgonine and ecgonine methyl ester. The action of carboxyl esterase is significant because it efficiently breaks down cocaine in the liver, leading to its detoxification and elimination from the body.

Cocaine itself is a lipophilic compound that rapidly crosses biological membranes, and the metabolism via carboxyl esterase provides a rapid means for the body to eliminate its effects. Understanding this metabolic pathway is essential for professionals in addiction medicine, as it pertains to the pharmacokinetics of cocaine and informs treatment approaches for cocaine use disorder. This foundational knowledge also highlights the importance of enzyme activity in drug metabolism and the implications for individual variations in response to substances.