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Enzymes called cyclooxygenase (COX) are essential for the body's inflammatory response. Specifically, COX-2 is an enzyme that activates in an inflammatory environment, resulting in prostaglandin synthesis, which in turn causes pain, fever, and edema. Compared to non-selective COX inhibitors, COX-2-selective medicines may have fewer gastrointestinal adverse effects and provide anti-inflammatory benefits by specifically targeting and inhibiting the COX-2 enzyme. In 1998, the FDA authorized celecoxib, the first COX-2-selective inhibitor, which represented a major breakthrough in the treatment of inflammatory disorders and pain management. Celecoxib, in contrast to conventional non-steroidal anti-inflammatory medicines (NSAIDs) like ibuprofen and naproxen, selectively inhibits the COX-2 enzyme, hence lowering the risk of gastrointestinal bleeding and stomach ulcers that are frequently linked to non-selective NSAIDs. Patients suffering from long-term inflammatory diseases like arthritis now have hope thanks to the development of COX-2-selective medicines. With their more focused approach, these drugs lessened pain and inflammation while sparing the stomach lining from further harm. On the other hand, worries over cardiovascular hazards arising from long-term COX-2 inhibitor use surfaced. Research revealed that COX-2 inhibitors may raise the risk of strokes and heart attacks, which led to a more thorough analysis of their safety profile. Because of this, rofecoxib (Vioxx) was taken off the market in 2004 because of worries about cardiovascular problems. The FDA then released alerts regarding the cardiovascular dangers associated with all COX-2 inhibitors, including celecoxib. COX-2 inhibitors are nonetheless useful in the treatment of some illnesses, especially when gastrointestinal problems are a major worry, notwithstanding these reservations. When prescribing these drugs, doctors carefully examine the advantages and disadvantages, taking into account specific patient characteristics including cardiovascular health and ulcer history. An important advancement in the management of inflammatory diseases is the discovery of COX-2-selective inhibitors, which provide an option for patients who are intolerant of conventional NSAIDs. The goal of ongoing research is to better understand the cardiovascular risks connected to these medications and optimize their use to optimize advantages while reducing potential dangers.