How Mononucleosis Is Treated

Doctor checks patient for swollen lymph nodes

FatCamera / Getty Images

Table of Contents
View All
Table of Contents

Mononucleosis (mono) is a viral illness most commonly caused by the Epstein-Barr virus (EBV), though it can be caused by other viruses. Treatment involves managing symptoms while your body fights the infection. Symptoms can include extreme fatigue, sore throat, and swollen tonsils.

Getting plenty of rest, drinking ample fluids, and taking over-the-counter (OTC) fever and pain relievers can help you recover. Prescription medication usually isn't needed, but corticosteroids can help reduce overly swollen tonsils in extreme cases.

This article covers home remedies, medications, and other strategies to help you manage your mono symptoms and recover as quickly as possible.

How to treat mononucleosis.

Verywell / Ellen Lindner

Home Remedies and Lifestyle

The primary treatment for mono involves rest and home remedies to relieve symptoms. Give your immune system the boost it needs to fight mono with the following tactics.


Fever and pain when swallowing can you put you at risk for dehydration. Prevent dehydration by drinking at least four to six cups of water per day. If you have a fever and are sweating a lot, you may need to drink more.


Don't underestimate the power of rest to help your immune system do its job. You'll especially need to get lots of rest in the first week or two that you are sick. This doesn't mean you have to stay in bed all the time, but you should greatly limit your activity.

While stimulants, like caffeine, might seem like a good idea when you're tired, it's best to let yourself rest. Avoid anything that will interfere with you getting quality sleep, which your immune system needs to stay strong. Kids with mono should be encouraged to take a break from active play.

Control Your Fever

Lowering the temperature of your room, taking a lukewarm (not cold) bath, and putting a cold washcloth on your forehead can help keep your fever down.

If you cannot bring your fever down within ten days, you should seek medical attention to avoid dangerous complications.

Reduce Sore Throat and Tonsil Swelling

The sore throat that comes with mono can be quite severe. Mono can cause tonsils to swell so much that they almost touch each other. You might also notice that your tonsils have a whitish-yellow covering.

A warm salt water gargle can help soothe your tonsils. You can also drink cold beverages, eat frozen yogurt or ice cream, or have a popsicle.

Soothe Body Aches

You can use ice packs or heating pads to relieve body aches, taking care to never apply ice directly to your skin. If your body aches (or any other symptoms) become intolerable, contact your healthcare provider.

Protect Your Spleen

It is important to avoid contact sports, heavy lifting, and strenuous activities when you have mono. The illness commonly causes an enlarged spleen, which can rupture upon even the mildest pressure or hit to the abdomen.

Spleen rupture as a complication of mono is rare and only occurs in less than 0.5% of cases. If it does happen, though, it is a medical emergency.

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. Wait at least until all your mono symptoms have resolved, then return to your physical activities gradually.

Avoid Alcohol

Mono can also cause the liver to become inflamed—a temporary condition known as mono hepatitis. Take it easy on your liver and avoid drinking alcohol while you have mono symptoms or are recovering.

Many people recover from mono within two to four weeks. However, some people continue to feel fatigued for several weeks longer. In some cases, mono symptoms can last for six months or more.

Over-the-Counter Therapies

You can typically manage a sore throat, fever, and body aches 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.

Adults may use aspirin, but it should not be given to anyone under the age of 19 due to the risk of a rare but life-threatening condition called Reye's syndrome. The risk of developing Reye's is higher when a child takes aspirin during or shortly after a viral illness, such as mono.

Aspirin belongs to a family of compounds called salicylates. While many salicylates share the same properties as aspirin, their effects on the body can vary. Taking too many salicylates at any age can lead to salicylate toxicity (overdose).

To avoid this medical emergency, check all OTC products you are using for aspirin and other salicylates, including acetylsalicylate, acetylsalicylic acid, and salicylic acid.

People younger than 19 should avoid using oral or topical medications that contain these ingredients as long as they have mono symptoms. Adults ages 19 and up should avoid using more than one salicylate or aspirin-containing product at a time.

Keep in mind that OTC pain relief ointments that contain menthol, such as Tiger Balm and Icy-Hot can contain salicylates as well. While topical salicylates have not been proven to be associated with Reye's syndrome, some people choose to avoid them until age 19.

Contact your healthcare provider if you have any questions about which medications you or your child should take when sick with mono.


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, in which your body does not make enough red blood cells fast enough.

It is possible to have strep throat or a bacterial sinus infection at the same time that you have mono. If this happens, you may be prescribed an antibiotic.

You shouldn't take penicillin antibiotics like ampicillin or amoxicillin when you have mono. For some people, this can cause a rash even though they're not allergic to the drug. When a person has mono, their chances of developing this rash are higher.

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.

Mono can result in other complications 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


Mono is a viral illness so it's not treated with antibiotics. Ample rest and hydration are critical for your immune system to fight the infection.

Over-the-counter medications can help keep your fever down and relieve aches. Children under 19 years of age should avoid medications that contain aspirin. Due to the risk of rupturing your spleen while sick with mono, you should avoid physical activities until your symptoms have passed.

A Word From Verywell

A common myth about mono is that you can only get it once. That's not exactly true. Once you become infected with Epstein-Barr virus, you will carry the virus for the rest of your life. The virus usually stays dormant and most people will never have mono symptoms again.

There is a chance, however, that EBV will reactivate and cause illness, mostly in people with weakened immune systems. If you have AIDS, autoimmune disease, cancer, or another condition that affects your autoimmune system, talk to your healthcare provider about how to reduce your risk.

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 you're contagious while you have symptoms, which typically last for four weeks or more.

    However, after you recover, the Epstein-Barr virus that most often causes mono remains dormant (inactive) in your body permanently.

    That doesn't mean you're infectious for the rest of your life. There's a small chance it could become active again and could be transmissible via saliva.

18 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.
  1. Centers for Disease Control and Prevention. About infectious mononucleosis.

  2. Kofteridis D, Valachis A. Mononucleosis and Epstein–Barr virus infection: treatment and medication. VAT. 2012 Feb;2012(4):23-28. doi:10.2147/vaat.s17837

  3. Harvard Health Publishing. How much water should you drink?. Published March 2020.

  4. Lennon P, Crotty M, Fenton JE. Infectious mononucleosis. BMJ. 2015 Apr;350(1):h1825. doi:10.1136/bmj.h1825

  5. Centers for Disease Control and Prevention. NIOSH training for nurses on shift work and long work hours.

  6. Harvard Health Publishing. Fever in adults. Harvard Health.

  7. Mount Sinai. Mononucleosis information.

  8. Lee S, Lin A, Baerg J, Wu E. Spontaneous splenic rupture secondary to Epstein-Barr virus-induced infectious mononucleosis. J Pediatr Surg Case Rep. 2020 Dec;63(1):101680. doi:10.1016/j.epsc.2020.101680

  9. Becker JA, Smith JA. Return to play after infectious mononucleosis. Sports Health. 2014;6(3):232-8. doi:10.1177/1941738114521984

  10. Stanford Children's Health. Reye syndrome in children.

  11. Delaney T, Helvey J, Shiffermiller J. A case of salicylate toxicity presenting with acute focal neurologic deficit in a 61-year old woman with a history of stroke. Am J Case Rep. 2020 Feb;21(1):1-5. doi:10.12659/AJCR.920016

  12. National Institute of Neurological Disorders and Stroke. Reye's syndrome.

  13. Magrum B, Pickworth K. Aspirin rechallenge in an adult patient previously diagnosed with Reye syndromeAm J Health-Syst Pharm. 2020 Jan;77(2):123-127. doi:10.1093/ajhp/zxz276

  14. Salama A. Treatment options for primary autoimmune hemolytic anemia: A short comprehensive review. Transfus Med Hemother. 2015 Sep;42(5):294-301. doi:10.1159/000438731

  15. Ónodi-Nagy K, Kinyó Á, Meszes A, Garaczi E, Kemény L, Bata-Csörgő Z. Amoxicillin rash in patients with infectious mononucleosis: evidence of true drug sensitization. Allergy Asthma Clin Immunol. 2015 Jan;11(1):1. doi:10.1186/1710-1492-11-1

  16. De Paor M, O'Brien K, Fahey T, Smith S. Antiviral agents for infectious mononucleosis (glandular fever). Cochrane Rev. 2016 Dec;2016(12):1-38. doi:10.1002/14651858.CD011487.pub2

  17. Kerr J. Epstein-Barr virus (EBV) reactivation and therapeutic inhibitors. J Clin Pathol. 2019 Jul;72(1):651-658.

  18. Centers for Disease Control and Prevention. About Epstein-Barr virus (EBV).

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.