Stable angina pectoris

At the onset of an attack: one or two metered sprays (400 to 800 micrograms) to be sprayed under the tongue while holding breath. May be repeated at five-minute intervals for a total of three sprays (maximum 1.2 mg within 15 minutes).

Not for use under 18 years.

Glyceryl Trinitrate Spray 400 micrograms/metered dose sublingual spray SmPC section 4.2 (eMC product 674)

No sublingual glyceryl trinitrate tablet is registered in Egypt. The spray is the only rapid-onset form on sale - the sustained-release capsules are for prevention and will not stop an attack.

Stable Angina - disease-level clinical article (angina-pectoris-clinical.txt)

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

80 mg once daily

(Children ≥10 years (familial hypercholesterolemia): Initially 10 mg once daily, increased to 40 mg once daily at intervals of at least 4 weeks; maximum 80 mg per day.)

Atorvastatin is the first choice here; aspirin is a further option.

Egyptian National Drug Formulary - Cardiovascular 2024 (atorvastatin monograph, Dosage Regimen, Secondary prevention of cardiovascular events)

High-intensity statin therapy for secondary prevention in stable coronary artery disease. Reviewed in August 2026: the 80 mg sits inside the article's high-intensity band and is the Egyptian formulary's own figure for this indication, so the card's statin coverage was already adequate and no dose changed. What was wrong was the citation - it named the Egyptian National Drug Formulary's cardiovascular volume with no year, no monograph and no section, so it could not be re-found.

75 to 162 mg once daily, in every patient with stable angina. - lifelong

1-5 mg/kg/day [child max 75 mg]

(Child 1 month-11 years: 1-5 mg/kg once daily, no single dose above 75 mg; Child 12-17 years: 75 mg once daily. The article cited here is adult-only and states no paediatric dose - it gives aspirin as 75 mg to 162 mg once daily, lifelong, in all patients with stable angina. Stable angina in a child is not a primary-care diagnosis: it points to congenital or acquired coronary disease, and needs paediatric cardiology.)

Stable angina pectoris - disease-level clinical article (angina-pectoris-clinical.txt) for the indication and the adult dose; the paediatric band above is from Egyptian National Drug Formulary - Cardiovascular 2024 (acetylsalicylic acid monograph): "Child 1 month-11 years: 1-5 mg/kg once daily (max. per dose 75 mg); Child 12-17 years: 75 mg once daily", given there for antiplatelet prevention of thrombus formation after cardiac surgery - not for this indication.

Lifelong antiplatelet therapy to reduce risk of myocardial infarction, stroke, and death in patients with stable angina.

Initially 5–10 mg twice daily, then increased if necessary and tolerated up to 40 mg twice daily.

Not recommended for pediatric patients.

Egyptian National Drug Formulary - Cardiovascular

Second-line potassium-channel opener antianginal agent for patients with stable angina.

75 mg once daily - Lifelong

The ENDF clopidogrel monograph gives no paediatric dose, so none is stated here.

Egyptian National Drug Formulary - Cardiovascular 2024 (clopidogrel monograph)

The disease article puts every stable angina patient on lifelong antiplatelet therapy, with clopidogrel for the aspirin-intolerant. Aspirin is already on the card and keeps its place; this is the alternative for those who cannot take it.

20 mg twice daily, the two doses 7 hours apart (e.g. 08:00 and 15:00) to leave a nitrate-free interval

Not indicated in children

Egyptian National Drug Formulary, cardiovascular 2025, isosorbide-5-mononitrate monograph (printed p. 62)

Long-acting nitrate that dilates veins and coronary arteries, lowering cardiac preload and oxygen demand to relieve and prevent anginal chest pain; its benefit depends on preserving the nitrate-free interval set out in the cautions, without which tolerance develops.

100 mg once daily, or 50 mg twice daily. Increasing beyond this is unlikely to add benefit

Not recommended in children - the label states there is no paediatric experience with atenolol.

Atenolol 50 mg Tablets SmPC section 4.2 (eMC product 14294)

18 live products and one of the cheapest antianginals on the Egyptian market. The formulary lists long-term management of angina pectoris as a named indication with a clean once-daily dose.

5 to 10 mg once daily

The ENDF gives a paediatric amlodipine dose for hypertension only (children 6 years and over, initial 2.5 mg once daily, maximum 10 mg/day) and none for angina, so no paediatric angina figure is stated here.

Egyptian National Drug Formulary - Cardiovascular 2024 (amlodipine monograph, angina pectoris indication)

The disease article names a calcium channel blocker as the alternative for symptom control when a beta-blocker is contraindicated, not tolerated, or insufficient - for example in reactive airway disease. The card offered atenolol alone. The ENDF gives amlodipine an explicit chronic stable angina dose.

Perindopril arginine 5 mg once daily (2.5 mg in the elderly) for 2 weeks, then increased as tolerated to 10 mg once daily; perindopril erbumine 4 mg once daily (2 mg in the elderly) for 2 weeks, then increased as tolerated to 8 mg once daily

Not applicable - stable angina is an adult disease and the ENDF gives no paediatric perindopril dose.

Egyptian National Drug Formulary - Cardiovascular 2024 (perindopril monograph, stable coronary artery disease)

The article recommends an ACE inhibitor or ARB in stable angina, particularly with coexisting hypertension, left ventricular dysfunction, diabetes or chronic kidney disease, but names no agent. Perindopril is the one the ENDF names for this exact condition - it carries a separate stable coronary artery disease indication and a dose written for it, rather than the hypertension dose borrowed.

10 mg once daily, with or without food

No paediatric dose for this indication in the sources opened.

Ezetimibe DailyMed label, SetID 11828685-dc27-42d8-a6ff-f110018207d1, section 2 - verbatim: "The recommended dose of ezetimibe tablets is 10 mg orally once daily, administered with or without food."

The card stops at high-dose atorvastatin, so it has no answer for the common case where the cholesterol is still too high on a maximal statin. This is the article's next step and a GP can add it.