Crystal structures of potassium (K(+)) channels reveal that the selectivity filter, the narrow portion of the pore, is only approximately 3-A wide and buttressed from behind, so that its ability to expand is highly constrained, and the permeation of molecules larger than Rb(+) (2.96 A in diameter) is prevented. N-methyl-d-glucamine (NMDG(+)), an organic monovalent cation, is thought to be a blocker of Kv channels, as it is much larger (approximately 7.3 A in mean diameter) than K(+) (2.66 A in diameter). However, in the absence of K(+), significant NMDG(+) currents could be recorded from human embryonic kidney cells expressing Kv3.1 or Kv3.2b channels and Kv1.5 R487Y/V, but not wild-type channels. Inward currents were much larger than outward currents due to the presence of intracellular Mg(2+) (1 mM), which blocked the outward NMDG(+) current, resulting in a strong inward rectification. The NMDG(+) current was inhibited by extracellular 4-aminopyridine (5 mM) or tetraethylammonium (10 mM), and largely eliminated in Kv3.2b by an S6 mutation that prevents the channel from opening (P468W) and by a pore helix mutation in Kv1.5 R487Y (W472F) that inactivates the channel at rest. These data indicate that NMDG(+) passes through the open ion-conducting pore and suggest a very flexible nature of the selectivity filter itself. 0.3 or 1 mM K(+) added to the external NMDG(+) solution positively shifted the reversal potential by approximately 16 or 31 mV, respectively, giving a permeability ratio for K(+) over NMDG(+) (P(K)(+)/P(NMDG)(+)) of approximately 240. Reversal potential shifts in mixtures of K(+) and NMDG(+) are in accordance with P(K)(+)/P(NMDG)(+), indicating that the ions compete for permeation and suggesting that NMDG(+) passes through the open state. Comparison of the outer pore regions of Kv3 and Kv1.5 channels identified an Arg residue in Kv1.5 that is replaced by a Tyr in Kv3 channels. Substituting R with Y or V allowed Kv1.5 channels to conduct NMDG(+), suggesting a regulation by this outer pore residue of Kv channel flexibility and, as a result, permeability.