Q: Why Vasotec (Enalapril) never got popular as an intravenous anti-hypertensive in ICUs?

Answer:   Vasotec (Enalapril) can be use as an anti-hypertensive in doses from 0.625 – 5 mg IV q6 hours.

Though initial BP reduction occurs in 15 minutes but full response may not occur for up to 4-6 hours after  first dose and in many instances may lead to cumulative effect of various doses, causing massive drop in BP.