1.4 Anti-anginal drug treatment General recommendations 1.4.1 Offer people optimal drug treatment for the initial management of stable angina. Optimal drug treatment consists of one or two anti-anginal drugs as necessary plus drugs for secondary prevention of cardiovascular disease. 1.4.2 Advise people that the aim of anti-anginal drug treatment is to prevent episodes of angina and the aim of secondary prevention treatment is to prevent cardiovascular events such as heart attack and stroke. 1.4.3 Discuss how side effects of drug treatment might affect the person's daily activities and explain why it is important to take drug treatment regularly. 1.4.4 Patients differ in the type and amount of information they need and want. Therefore the provision of information should be individualised and is likely to include, but not be limited to: what the medicine is how the medicine is likely to affect their condition (that is, its benefits) likely or significant adverse effects and what to do if they think they are experiencing them how to use the medicine what to do if they miss a dose whether further courses of the medicine will be needed after the first prescription how to get further supplies of medicines. [This recommendation is from the NICE guideline on medicines adherence.] 1.4.5 Review the person's response to treatment, including any side effects, 2 to 4 weeks after starting or changing drug treatment. 1.4.6 Titrate the drug dosage against the person's symptoms up to the maximum tolerable dosage. Drugs for treating stable angina 1.4.7 Offer either a beta blocker or a calcium channel blocker as first-line treatment for stable angina. Decide which drug to use based on comorbidities, contraindications and the person's preference. 