What are the treatment and management options for infectious mononucleosis (mono)?

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Last updated: March 14, 2025 • View editorial policy

From the Research

The treatment of mononucleosis (mono) primarily focuses on supportive care since it's a viral infection that resolves on its own, with rest, hydration, and over-the-counter pain relievers being essential for recovery, as stated in the most recent review 1. The management of mono involves a combination of symptomatic relief and prevention of complications.

  • Rest is essential for recovery, which typically takes 2-4 weeks, though fatigue may persist longer.
  • Staying hydrated and taking over-the-counter pain relievers like acetaminophen (Tylenol, 650mg every 6 hours) or ibuprofen (Advil, 400-600mg every 6-8 hours) can help manage fever and sore throat.
  • Gargling with warm salt water (1/2 teaspoon salt in 8oz warm water) several times daily can also help relieve throat discomfort.
  • Avoiding strenuous physical activity and contact sports for at least 3-4 weeks is crucial to prevent splenic rupture, as the spleen often enlarges during mono, as noted in a study on infectious mononucleosis in athletes 2.
  • Alcohol should be avoided while recovering to prevent additional liver stress, as mono can cause liver inflammation.
  • Corticosteroids are occasionally prescribed for severe throat swelling but aren't routine, and should be reserved for those with impending airway obstruction, autoimmune complications, or other severe circumstances, as suggested by a recent review on corticosteroids for infectious mononucleosis 3.
  • Antibiotics like amoxicillin should be avoided unless there's a confirmed bacterial co-infection, as they can cause a rash in mono patients. Most people recover completely without specific antiviral treatment, as the body naturally clears the Epstein-Barr virus that causes mono, though the virus remains dormant in the body afterward, as discussed in a recent review on infectious mononucleosis 1.

References

Research

Infectious Mononucleosis: An Updated Review.

Current pediatric reviews, 2024

Research

Infectious Mononucleosis Management in Athletes.

Clinics in sports medicine, 2019

Research

Corticosteroids for infectious mononucleosis.

Canadian family physician Medecin de famille canadien, 2023

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