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Medications to Treat Postherpetic Neuralgia Tricyclic antidepressants, such as amitriptyline, desipramine (Norpramin), and nortriptyline, have pain-modulating effects in neuropathic and other chronic pain states

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You might wonder how a pill works if you lack intrinsic factor: at very high oral doses, a small amount of B12 can be absorbed directly through the gut wall via passive diffusion, bypassing the need for intrinsic factor entirely [1] [3]

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Severe deficiency can lead to irreversible brain and nerve damage

Never change the dose or frequency without consulting the prescribing healthcare provider