Positives

• A documented case of severe adrenaline-resistant anaphylactic shock in a beta-blocker patient was successfully reversed with glucagon after epinephrine failed PMC.
  
  
• Glucagon bypasses beta receptors and produces inotropic and chronotropic support, which is uniquely useful for MCAS/POTS patients on beta-blockers when EpiPens fail NCBI Bookshelf.
  
  

Negatives

• Patients given glucagon often experience severe nausea and vomiting that can complicate airway management during an active anaphylactic episode AAAAI.
  
  
• Evidence remains limited to case reports rather than randomized trials, leaving patients and EMS uncertain about exact dosing and timing American Journal of Therapeutics.
  
  

Hurdles & Side Effects

• Most patients cannot obtain a home glucagon kit specifically for anaphylaxis rescue because the indication is off-label and prescribers default to EpiPens Frontiers.
  
  
• Even when glucagon is available, EMS and ER staff often have to be coached in real time about why epinephrine alone will not work in beta-blocker users with MCAS PMC.