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E1 is a TPP-dependent -ketoacid dehydrogenase, E2 is a dihydrolipoamide transacetylase that binds one or two lipoyl groups via covalent amide linkages to lysine residues, and E3 is an FAD-containing dihydrolipoamide dehydrogenase that re-oxidizes dihydrolipoamide using NAD +

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The medication acts as a dual agonist for the glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors