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By inhibiting PDE-5 enzyme activity, it prevents the degradation of cyclic guanosine monophosphate (cGMP), thereby relaxing smooth muscles, dilating blood vessels, and enhancing blood flow

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This dual action of promoting fat breakdown while simultaneously reducing fat storage creates the net effect of adipose tissue reduction, all occurring at the peripheral tissue level without involvement of central appetite-regulating pathways in the hypothalamus

Linagliptin, however, uses a distinct elimination route, as the majority of the drug is eliminated through the hepatobiliary system and, thus, is more favorable in cases of renal dysfunction [31]