There is currently no treatment to kill the virus that causes mononucleosis; therefore, treatment goals are focused on providing relief of mono symptoms as the body fights the virus.
Cold drinks and frozen desserts are both ways to relieve sore throat symptoms. Doctors also recommend gargling with salt water (about half a teaspoon of salt to 8 ounces of warm water), and sucking on throat lozenges, available over-the-counter in pharmacies and other stores.
If the throat or tonsils are infected, a throat culture should be taken so the doctor can prescribe an appropriate antibiotic. Ampicillin is usually not recommended because it sometimes causes a rash that can be confused with the pink, measles-like rash that 1 out of 5 mono patients develop.
For fever and achiness, you can take acetaminophen (marketed as Tylenol, Datril, and others) or ibuprofen (marketed as Advil, Motrin, Nuprin, and others). If you’re under 20, don’t take aspirin unless your doctor approves it. In children and teens, aspirin taken for viral illnesses has been associated with the potentially fatal disease known as Reye’s syndrome.
For treating mono, some physicians prescribe a 5-day course of steroids, to control the swelling of the throat and tonsils. The use of steroids has also been reported to decrease the overall length and severity of the illness, but these reports have not been published.
Whether or not the spleen is enlarged, people who have mono should not lift heavy objects or exercise vigorously — including participating in contact sports — for two months after they get sick, because these activities increase the risk of rupturing the spleen, which can be life threatening. If you have mono and get a severe, sharp, sudden pain on the left side of your upper abdomen, go to an emergency room or call 911 immediately.
Bed rest is the most important part of treating mono. It’s also important to drink plenty of fluids. Mono is not usually a reason to quarantine students. Many people are already immune to the viruses that cause mono; however, if you have mono, you’ll want to stay in bed and out of classes for several days, until the fever goes down and other symptoms subside. Even when you’ve started to get better, you can expect to have to limit your activities for several weeks. It can take two to three months or more until you feel your old self again.