Make ABSOLUTELY certain that you agree on the price and the currency before getting into the carriage. Some of the drivers will quote a reasonable sounding price and then at the end of the ride into downtown try and get the price in US $ instead of Egyptian $.
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At Least Do This: Be very clear before you ever get in which currency you are using.
Alternative: I had to threaten our carriage driver with reporting him to the Tourist Police when he tried the currency switch. If need be, get loud and DO NOT back off, it only encourages them to rip off the next tourist (kind of like feeding the bears in Yellowstone).
The walk downtown isn't far and pretty level so using your feet is a reasonable alternative. Taxi cabs are OK as well for longer trips like up to the mosque which is a fair hike up a hill.