Home care for mononucleosis includes:

• Avoid alcohol.
• Stop smoking.
• Avoid exposure to secondary smoke.
• Drink plenty of liquids.
• Soothe the throat with throat spray, throat lozenges, warm soup or hard candy.
• Take nonprescription medication for sore throat:
• Sore throat sprays
• Sore throat lozenges
• Gargle with warm salt water.
• Place a vaporizer or nebulizer in the bedroom at night.
• Acetaminophen for pain
• Nonsteroidal anti-inflammatory medications for pain:
• Ibuprofen (Motrin, Advil, Nuprin, NeoProfen)
• Ketoprofen (Actron, Orudis, Oruvail)
• Naproxen (Anaprox, Naprosyn, Aleve)
• Take prescribed medications as directed:
• Don't skip doses of your medication. This makes them less effective.
• Be aware of the common side effects that may be caused by your medication.

Medications commonly used to control pain and fever in adults with mononucleosis include:

• Acetaminophen
• Nonsteroidal anti-inflammatory drugs:
• Aspirin
• Ibuprofen
• Naproxen
• Ketoprofen

• Acetaminophen decreases fever and pain, but does not help inflammation.
• Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
• Maximum dose is 4,000 mg per day.
• Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
• Common brand names include Tylenol, Panadol, and many others.

• Aspirin decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is two regular strength (325 mg) every 4 hours with food.
• There are numerous products that contain aspirin.
• Follow the package instructions and NSAID precautions (below).

• Ibuprofen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is 200-400 mg every 4-6 hours.
• Do not exceed 1,200 mg per day without a doctor's recommendation.
• Brand names include Advil, Motrin and Nuprin.
• Follow the package instructions and NSAID precautions (below).

• Naproxen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is 200 or 220 mg twice a day with food.
• Do not exceed 500 mg per day.
• Its brand name is Aleve.
• Follow the package instructions and NSAID precautions (below).

• Ketoprofen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is 12.5 mg every 4-6 hours with food.
• Do not exceed 75 mg per day.
• Its brand name is Orudis KT.
• Follow the package instructions and NSAID precautions (below).

• Avoid using alcohol when taking any of these medications.
• Do not mix prescription and non-prescription NSAIDS unless directed to do so by your doctor.
• NSAIDS can interact with other blood thinners, such as Coumadin, and cause bleeding complications.
• Ask your doctor before using an NSAID if you are pregnant or breastfeeding.
• Ask your doctor before using an NSAID if you have a history of:
• Allergy to aspirin
• Asthma
• Peptic ulcer disease
• Stomach ulcers
• Esophageal ulcers
• Bleeding problems
• Liver disease
• Kidney disease

Common medications used for pain and fever in children with mononucleosis include:

• Acetaminophen
• Ibuprofen
• Naproxen (must be 13 or older)

• Acetaminophen decreases fever and pain, but does not help inflammation.
• Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
• Do not exceed the maximum daily dose.
• Acetaminophen products come in various strengths. Always follow the package instructions.
• Avoid this drug in children with liver disease or an allergy to acetaminophen.
• Common acetaminophen products include Tylenol, Panadol and many others.

• Ibuprofen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Dosing for children over 6 months of age is 7-10 mg per kilogram (4-5 mg per pound) of body weight every 6 hours, up to the adult dose.
• Do not exceed the maximum daily dose.
• Always follow the package instructions.
• Avoid this drug in children with liver, kidney, stomach or bleeding problems.
• Brand names include Advil, Motrin and Nuprin.

• Naproxen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Dosing for 13 and older is 200 mg twice a day with food.
• Do not exceed 500 mg per day.
• Always follow the package instructions.
• Avoid this drug in children with liver, kidney, stomach or bleeding problems.
• The brand name for naproxen is Aleve.

Home care for a sore throat in an adult with mononucleosis includes:

• Avoid alcohol.
• Avoid citrus juice.
• Avoid hot and spicy foods.
• Do not smoke and avoid exposure to secondary smoke.
• Drink plenty of fluids.
• Get plenty of rest.
• Numb the throat pain with throat spray or lozenges.
• Gargle with warm salt water several times a day. Mix 1/2 teaspoon (92.5 ml) salt per cup (240 cc) of water.
• Place a vaporizer or nebulizer in the bedroom at night.
• Take acetaminophen or ibuprofen for pain.

Home care for a sore throat in a child with mononucleosis includes:

• Avoid citrus juice.
• Avoid hot and spicy foods.
• Avoid exposure to secondary smoke.
• Drink plenty of fluids.
• Get plenty of rest.
• Numb the throat pain with throat spray or lozenges.
• Gargle with warm salt water several times a day. Mix 1/2 teaspoon (92.5 ml) salt per cup (240 cc) of water.
• Place a vaporizer or nebulizer in the bedroom at night.
• Take acetaminophen or ibuprofen for pain.

Home care for vomiting in an adult with mononucleosis includes:

• Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea.
• Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
• Avoid milk and dairy products for 3 days.
• Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
• If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
• Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

• Meclizine (Bonine)
• Dimenhydrinate (Dramamine)
• Bismuth subsalicylate (Pepto-Bismol)

Home treatment of vomiting in children with mononucleosis includes hydration and dietary therapy. Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in infants include:

• Infalyte
• Lytren
• Naturalyte
• Pedialyte
• Rehydralyte

• Sports drinks (Gatorade)
• Broth
• Dilute fruit juices
• Flat soda
• Weak tea with sugar

• If the infant tolerates breast milk, continue breast-feeding in small amounts very frequently.
• Provide additional ORT fluids to supplement breast milk.
• Feed very small amounts every 30-60 minutes, or try giving small amounts more frequently, such as:
• Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
• Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
• Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

• If the infant tolerates formula, continue to provide small amounts very frequently.
• Provide additional ORT fluids to formula.
• Try giving small amounts more frequently, such as:
• Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
• Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
• Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

• Provide as much ORT fluids as your child desires.
• If vomiting occurs, provide small amounts of ORT fluids more frequently:
• Children 10-20 kg (22-44 lb): 15 ml (1 tablespoon) every 5 minutes
• Children 20-40 kg (44-88 lb): 22 ml (1 and 1/2 tablespoons) every 5 minutes
• Children 40 kg (88 lb) and over: 30 ml (2 tablespoons) every 5 minutes
• Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

• Crackers
• Oatmeal
• Jell-O
• Soft foods
• Yogurt

• Concentrated fruit juices
• Junk foods
• Milk products
• Recently introduced foods
• Spicy foods

Notify your doctor if you have mononucleosis and you develop any of the following:

• Abdominal pain
• Difficulty breathing
• Fever over 104 degrees F (40 C)
• Inability to open the mouth
• Throat swelling:
• Worsening swelling of one tonsil
• Inability to swallow
• Persistent vomiting
• Worsening throat pain
• Worsening dry mouth
• Worsening gland swelling in the neck
• Jaundice:
• Yellow skin
• Yellow eyes
• Brown urine

Last Updated: Mar 14, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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