I have a large number of PDF files which have two slides to a page (for printing).
The format is A4 pages each with two slides setup like so:
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If using a Java or .Net library is ok for you, you can use iText / iTextSharp.
An example for tiling an existing document can be found in the book iText in Action, 2nd edition, in the freely available chapter 6: TilingHero.java / TilingHero.cs.