The ingredients on my bottle say: methylcobalamin (methyl-B12), RG3 (ginsenoside), nicotinamide riboside, MCT oil, DMSO, and a few things that I can't read without a magnifying glass.
My LLMD had me try RG3 and had a lot of confidence in it. Failed for me. When it didn't work we went away from nasal sprays then later came back with the option of either nasal glutathione or oral CBD. I tried the glut first and it helped, so I never got to the CBD. I should probably point out that by time I got to the nasal glut I had already had a significant reduction in head pressure from the other treatments I was doing, so it didn't have as big a task as the RG3 did.