ATP-dependent transporter of the ATP-binding cassette (ABC) family that actively extrudes physiological compounds and xenobiotics from cells. Transports a range of endogenous molecules that have a key role in cellular communication and signaling, including cyclic nucleotides such as cyclic AMP (cAMP) and cyclic GMP (cGMP), bile acids, steroid conjugates, urate, and prostaglandins (PubMed:11856762, PubMed:12883481, PubMed:12523936, PubMed:12835412, PubMed:15364914, PubMed:15454390, PubMed:16282361, PubMed:17959747, PubMed:18300232, PubMed:26721430). Mediates the ATP-dependent efflux of glutathione conjugates such as leukotriene C4 (LTC4) and leukotriene B4 (LTB4) too. The presence of GSH is necessary for the ATP-dependent transport of LTB4, whereas GSH is not required for the transport of LTC4 (PubMed:17959747). Mediates the cotransport of bile acids with reduced glutathione (GSH) (PubMed:12883481, PubMed:12523936, PubMed:16282361). Transports a wide range of drugs and their metabolites, including anticancer, antiviral and antibiotics molecules (PubMed:11856762, PubMed:12105214, PubMed:15454390, PubMed:18300232, PubMed:17344354). Confers resistance to anticancer agents such as methotrexate (PubMed:11106685). ATP + H2O + xenobioticSide 1 = ADP + phosphate + xenobioticSide 2. an S-substituted glutathione(in) + ATP + H2O = ADP + an S-substituted glutathione(out) + H(+) + phosphate 17beta-estradiol 17-O-(beta-D-glucuronate)(in) + ATP + H2O = 17beta-estradiol 17-O-(beta-D-glucuronate)(out) + ADP + H(+) + phosphate ATP + dehydroepiandrosterone 3-sulfate(in) + H2O = ADP + dehydroepiandrosterone 3-sulfate(out) + H(+) + phosphate ATP + H2O + leukotriene C4(in) = ADP + H(+) + leukotriene C4(out) + phosphate ATP + H2O + leukotriene B4(in) = ADP + H(+) + leukotriene B4(out) + phosphate ATP + H2O + urate(in) = ADP + H(+) + phosphate + urate(out) 3',5'-cyclic GMP(in) + ATP + H2O = 3',5'-cyclic GMP(out) + ADP + H(+) + phosphate 3',5'-cyclic AMP(in) + ATP + H2O = 3',5'-cyclic AMP(out) + ADP + H(+) + phosphate ATP + H2O + prostaglandin E2(in) = ADP + H(+) + phosphate + prostaglandin E2(out) ATP + H2O + prostaglandin E1(in) = ADP + H(+) + phosphate + prostaglandin E1(out) ATP + glutathione(in) + glycodeoxycholate(in) + H2O = ADP + glutathione(out) + glycodeoxycholate(out) + H(+) + phosphate ATP + cholate(in) + glutathione(in) + H2O = ADP + cholate(out) + glutathione(out) + H(+) + phosphate ATP + glutathione(in) + glycocholate(in) + H2O = ADP + glutathione(out) + glycocholate(out) + H(+) + phosphate ATP + glutathione(in) + H2O + taurocholate(in) = ADP + glutathione(out) + H(+) + phosphate + taurocholate(out) ATP + glutathione(in) + glycochenodeoxycholate(in) + H2O = ADP + glutathione(out) + glycochenodeoxycholate(out) + H(+) + phosphate ATP + glutathione(in) + H2O + taurochenodeoxycholate(in) = ADP + glutathione(out) + H(+) + phosphate + taurochenodeoxycholate(out) ATP + glutathione(in) + glycoursodeoxycholate(in) + H2O = ADP + glutathione(out) + glycoursodeoxycholate(out) + H(+) + phosphate ATP + glutathione(in) + H2O + tauroursodeoxycholate(in) = ADP + glutathione(out) + H(+) + phosphate + tauroursodeoxycholate(out) GSH stimulates the transport of MRP4 (PubMed:17959747). Urate inhibits methotrexate transport but stimulates cGMP transport (PubMed:15454390). Nonsteroidal anti-inflammatory drugs (NSAIDs) strongly suppress the transport of MRP4 substrates (PubMed:12835412). Interacts (via PDZ-binding motif) with SNX27 (via PDZ domain); this interaction accelerates MRP4 internalization. Its localization to the basolateral or apical membranes is tissue-dependent. Widely expressed, with particularly high levels in prostate, but is barely detectable in liver. sinusoidal membrane of hepatocytes. N-glycosylated; leading to substrate-selective effects on its transport activity. Belongs to the ABC transporter superfamily. ABCC family. Conjugate transporter (TC 3.A.1.208) subfamily. Database for mutations in ABC proteins