What product does cocaine primarily metabolize to in the liver?

Cocaine predominantly metabolizes into benzoylecgonine in the liver. This metabolite is significant for several reasons. First, benzoylecgonine is a key marker used in drug testing; its presence can indicate recent cocaine use due to its longer half-life compared to cocaine itself. While cocaine is rapidly eliminated, benzoylecgonine persists in the body for a much longer period, making it a reliable indicator for detecting cocaine use.

The metabolic pathway involves enzymatic processes that primarily occur in the liver, utilizing specific enzymes that break down cocaine into various metabolites, with benzoylecgonine being the most prominent. In some instances, norcocaine, another metabolite, is formed, but it is in smaller quantities and generally does not have the same relevance in drug testing.

Understanding the metabolic pathway of cocaine and its primary metabolites is crucial in addiction medicine, particularly for monitoring and treating substance use disorders. Benzoylecgonine's role in toxicology and pharmacology underscores its importance in clinical settings related to cocaine use.