How Mononucleosis Is Treated

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Treatment for mononucleosis (mono) is based on managing the symptoms as your body fights this viral illness. The most bothersome symptoms of mono include extreme fatigue, sore throat, and swollen tonsils. You can use over-the-counter (OTC) fever reducers and pain relievers while getting plenty of rest and fluids. Prescription medication usually isn't needed, but corticosteroids can help reduce overly swollen tonsils in extreme cases.

How to treat mononucleosis.

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Most symptoms resolve in about a month, but it can take longer. Fatigue may not fully resolve for up to six months. However, this is highly variable, so you may recover much faster. Children with mono can usually return to school once the fever is gone and they feel ready to return. That said, mono may be considered contagious for several months.

Home Remedies and Lifestyle

The primary treatment for mono involves rest and home remedies to relieve symptoms. You should also be sure to drink enough water to prevent dehydration, which is a risk when you have a fever or pain in swallowing. Use these tactics to give your immune system a boost to fight the virus.


Adequate rest is often recommended for the first week or two. You don't have to stay in bed all the time, but you should greatly limit your activity.

Many people with mono will feel extreme fatigue, which usually resolves in three to four weeks.

While stimulants, like caffeine, might seem like a good idea for combating tiredness, you really should just take the time to just rest. Avoid anything that will interfere with you getting quality sleep, which is necessary for a strong immune system. Kids with mono should be encouraged to take a break from active play.

Fever Relief

For a fever, in addition to OTC fever-reducing medication, you can lower the temperature of your room, take a lukewarm (not cold) bath, or put a cold washcloth on your forehead. If your fever remains uncontrolled after doing this, you should seek medical attention to avoid dangerous complications.

Sore Throat and Tonsil Swelling

The tonsils can swell to the point of almost touching.

You may even have heard others describe mono as the worst sore throat of their lives.

Soothe yourself with a warm salt water gargle. You can also drink cold beverages, eat frozen yogurt or ice cream, or have a popsicle.

Body Aches

You can use ice packs or heating pads to relieve body aches. Call your healthcare provider if the pain is still not tolerable.

Protecting the Enlarged Spleen

It is important to avoid contact sports, heavy lifting, and strenuous activities because the enlarged spleen seen in mononucleosis can rupture. This includes most team sports, cheerleading, and weightlifting. It is a good idea to avoid heavy chores around the house, as well. Children should be discouraged from rough play or wrestling with siblings. Easy exercises such as walking are fine as long as you don't feel too tired.

Avoid Alcohol

Adults are more likely to show liver involvement with mono. Because of this, you should not drink alcohol while you have mono symptoms or are recovering.

Over-the-Counter Therapies

You can typically manage a sore throat, fever, and body aches associated with mono by using OTC pain relievers like Tylenol (acetaminophen) and Motrin (ibuprofen). You can also find throat lozenges and sprays to soothe a sore throat. Check with your healthcare provider for advice on the appropriate pain and fever reducers, dosages, and timing for your age group or that of your child.

It's important to note the ingredients in all of the OTC medications you are taking as you may be getting acetaminophen in more than one product, which can cause an overdose.

While adults might use aspirin, it should not be given to anyone under the age of 19 due to the risk of Reye's syndrome. Be sure that you check any OTC products used for the symptoms of mono to ensure they do not contain ingredients with these words, which are synonyms for aspirin: acetylsalicylate, acetylsalicylic acid, salicylic acid, or salicylate.

Feeling achy can be quite common with mono. In addition to oral pain medications, you can use OTC pain relief ointments that contain menthol, such as Tiger Balm. You may wish to check the ingredient list for aspirin-containing compounds if the person with mono is under age 19. Unfortunately, many do contain salicylates, including Icy-Hot. While topical salicylates have not been proven to be associated with Reye's syndrome, some people choose to avoid them until age 19.


Swollen tonsils and lymph nodes usually are not a big deal and go away on their own. However, if they become so swollen that they interfere with swallowing or breathing, you need treatment right away. Sometimes steroid medications are used to shrink the tonsils if they have become too enlarged. Corticosteroids can also be used if there are complications such as very low platelet count or hemolytic anemia.

An extremely painful sore throat might even prompt a prescription narcotic.

Antibiotics are not used for mononucleosis because it is a viral disease. However, the symptoms can be mistaken for strep throat and an antibiotic may be prescribed. The use of amoxicillin or other forms of penicillin can produce a rash even when someone is not allergic to the drug, but that rash is more common in those with mono.

In some cases, strep throat or a bacterial sinus infection is present along with mono and antibiotic use is indicated. If so, you may be prescribed an antibiotic that is less likely to produce a rash.

There have been studies on using antiviral therapy for Epstein-Barr virus infectious mononucleosis, especially in patients who are at risk due to being immunocompromised. A review of this research found that any benefit was uncertain. The drugs used included acyclovir, valomaciclovir, and valacyclovir.

There are other complications of mono that may require prescription medication, which will vary based on the course of the illness.

Mononucleosis Healthcare Provider Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Frequently Asked Questions

  • What's the quickest way to recover from mono?

    Because it's a viral infection, there are no medications for mononucleosis: The illness simply needs to run its course. That said, you can help speed your recovery by getting lots of rest, especially when you first become ill, and drinking plenty of fluids.

  • Is mononucleosis a serious disease?

    Not usually. For most people, the most serious aspect of the illness is missed time from work, school, and social activities. One common side effect to be aware of is an enlarged spleen, which can be vulnerable to rupture during vigorous activities or contact sports. Don't engage in either until your healthcare provider says it's OK.

  • How long is mono contagious?

    Experts aren't totally sure. There's no question a person with mononucleosis is contagious while they have symptoms, which typically last for four weeks or more. However, after they recover, the Epstein-Barr virus that most often causes mono remains dormant (inactive) in their body permanently, but that doesn't mean someone is infectious for the rest of their lives. There's a small chance it could become active again and could be transmissible via saliva.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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