This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org/licenses/by/3.0) Conflict of interest: None declared | Source of funding: Nil | DOI: http://dx. Abstract:Beta-blockers and calcium channel blockers over-dosage have similar presentation with hypotension and bradycardia, with considerable overlap in treatment and are often refractory to resuscitation measures. A 15 years old female, previously healthy, presented to hospital 3 hours after ingestion of calcium channel blocker, β-blocker and acetaminophen. The patient presented with abdominal pain, hypotension and sinus bradycardia after ingestion of 100 mg of amlodipine and 100 mg of nebivolol and 15 gm acetaminophen. Gastric lavage with activated charcoal was done in private hospital, but because of her hemodynamic instability she was transferred to our hospital. Fluid resuscitation failure and increasing requirement of vasopressors (nor-adrenaline) required her admission to intensive care unit. She was treated with N-acetyl cysteine in view of raised acetaminophen level, insulin infusion, glucose supplementation with continuous monitoring of potassium and blood glucose. After 48 hours patient was hemodynamic stable without vasopressor support and discharged.