22nd May 2025

A 48-year-old patient with previous peptic ulcer disease, brittle asthma and angina complains of persistent exertional chest pain despite compliance with prescribed medications.

A 48-year-old patient with previous peptic ulcer disease, brittle asthma and angina complains of persistent exertional chest pain despite compliance with prescribed medications. He is currently taking a maximum dose of verapamil and isosorbide mononitrate for the management of angina. He would like to know whether the addition of paracetamol or codeine might help to manage his pain. What is the next best step in his management? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.