Angina pectoris is a leading cause of cardiovascular morbidity globally, yet gaps persist in personalized management. Effective clinical management approaches are essential to reduce the increasing burden of this potentially fatal and life-threatening disorder. The objective of this study is to evaluate the clinical management strategies, adverse drug reactions and potential drug-drug interaction in patient with angina pectoris. A cross-sectional study was conducted on n=100 patients with angina pectoris. Data was collected using a structured data collection form over 180 days, and chi-square for associations was performed using SPSS. Among older adults (age > 40 years) the prevalence of angina was found to be high, with 65% male and 35% female. The incidence was recorded significantly higher in patients with comorbidities such as hypertension and diabetes (p < 0.05). Twenty five percent (25%) of patients experienced adverse drug reactions. Additionally, 14 significant drug-drug interactions were identified with 57% considered of high severity. This study uniquely quantifies region-specific medication risks: 57% high-severity DDIs compared to 30-40% in Western cohorts and 25% ADRs in comorbid patients (60% HTN), providing LMIC-specific safety protocols.