Infections
Medicines for Glandular fever
A usually self-limiting viral infection, most often caused by the Epstein-Barr virus and common in teenagers and young adults — causing a severe sore throat, swollen glands, fever and marked fatigue that can last for weeks, with no specific cure beyond rest, fluids and simple pain relief.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Glandular fever?
Glandular fever, known medically as infectious mononucleosis, is a viral infection most commonly caused by the Epstein-Barr virus. It is particularly common in teenagers and young adults and spreads through saliva, which is why it has earned the nickname the "kissing disease" — though it can also pass on through sharing cups, cutlery or toothbrushes, and through coughs and sneezes.
- How it is treated: There is no specific cure for glandular fever, and because it is caused by a virus, antibiotics do not help.
- Self-care: Resting, drinking plenty of fluids and pacing a gradual return to normal activity all help while the fatigue settles.
- When to seek help: See your GP if you have a severe or long-lasting sore throat with swollen glands and persistent tiredness, so glandular fever can be considered and a blood test arranged if needed.
What it is
Glandular fever, known medically as infectious mononucleosis, is a viral infection most commonly caused by the Epstein-Barr virus. It is particularly common in teenagers and young adults and spreads through saliva, which is why it has earned the nickname the "kissing disease" — though it can also pass on through sharing cups, cutlery or toothbrushes, and through coughs and sneezes. The hallmark symptoms are a severe sore throat, often with very swollen tonsils, swollen lymph glands in the neck and elsewhere, a high temperature, and a profound, lingering tiredness that can persist for several weeks after the other symptoms have settled. Some people also notice a swollen, tender abdomen because the spleen — an organ in the upper left of the tummy — can become enlarged during the infection. The illness is usually self-limiting, meaning it gets better on its own, but the fatigue in particular can take time to fade and may interfere with school, work or sport for a while. Once you have had it, you generally develop lasting immunity.
How it is treated
There is no specific cure for glandular fever, and because it is caused by a virus, antibiotics do not help. Treatment is supportive — rest, plenty of fluids and simple pain-and-fever relief with paracetamol or ibuprofen to ease the sore throat, fever and aches while the body clears the infection. Two points need particular care. First, the antibiotics amoxicillin and ampicillin should be avoided if glandular fever is a possibility, because in someone with this infection they commonly trigger a widespread, blotchy skin rash. This is one reason a sore throat is sometimes managed cautiously before antibiotics are reached for. Second, because the spleen can become enlarged during the illness, contact and collision sports — and other activities risking a blow to the abdomen — should be avoided for several weeks, as an enlarged spleen is more fragile and can, rarely, rupture. Recovery is mostly a matter of patience, with a gradual return to normal activity as energy returns; some people need a phased return to school, work or training because the fatigue outlasts everything else.
For this condition, these medicines
Medicine classes used for Glandular fever
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Glandular fever
Glandular fever can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
Beyond medication
Lifestyle and self-care
Resting, drinking plenty of fluids and pacing a gradual return to normal activity all help while the fatigue settles. Avoiding alcohol while unwell is sensible, and contact or collision sports and other activities that could injure the abdomen should be avoided for several weeks because of the risk to an enlarged spleen. Not sharing cups, cutlery or toothbrushes helps reduce passing the virus to others.
When to get help
When to see a doctor
See your GP if you have a severe or long-lasting sore throat with swollen glands and persistent tiredness, so glandular fever can be considered and a blood test arranged if needed. Seek urgent help — call 999 or go to A&E — if you have difficulty breathing or swallowing, if your throat is so swollen that it is hard to keep your airway clear, or if you cannot drink and are becoming dehydrated. Sudden severe pain in the upper left of the abdomen or the left shoulder, especially after any knock to the tummy, needs emergency assessment because it can signal a rupture of the enlarged spleen. Because of this risk, avoid contact and collision sports for several weeks and check with your doctor before returning. Also seek advice if the fatigue is not improving over time or is severely affecting daily life.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Glandular fever: frequently asked questions
What medicines are used for glandular fever?
There is no specific medicine that cures glandular fever, and because it is a viral infection, antibiotics do not help. Treatment is supportive — rest, fluids and simple pain-and-fever relief such as paracetamol or ibuprofen to ease the sore throat, fever and aches. Importantly, the antibiotics amoxicillin and ampicillin should be avoided if glandular fever is possible, because they often cause a widespread rash in people with this infection. If a separate bacterial infection is suspected, a doctor will choose an antibiotic with this in mind. Most people recover with patience, rest and simple home care as the body clears the virus.
Why should amoxicillin be avoided in glandular fever?
In someone who has glandular fever, the antibiotics amoxicillin and ampicillin commonly trigger a widespread, blotchy red skin rash. This reaction is well recognised and is one reason doctors are cautious about reaching for these antibiotics when a sore throat could be glandular fever rather than a bacterial infection. The rash itself is not usually dangerous, but it is uncomfortable and can be mistaken for a drug allergy. Since glandular fever is viral, antibiotics would not help it anyway. If you have a sore throat and glandular fever is a possibility, it is worth mentioning so that these particular antibiotics can be avoided.
Why must I avoid contact sports with glandular fever?
During glandular fever the spleen — an organ tucked under the ribs on the upper left of the abdomen — can become enlarged, and an enlarged spleen is more fragile than usual. A blow or knock to the tummy, such as can happen in rugby, football, martial arts or other contact and collision sports, could cause it to rupture, which is a serious emergency. For this reason these sports and any activity risking an impact to the abdomen should be avoided for several weeks. Your doctor can advise when it is safe to return, as this depends on how the illness settles. Sudden severe pain in the upper left tummy or left shoulder needs emergency assessment.
How long does glandular fever last?
The main symptoms — sore throat, fever and swollen glands — usually ease within a couple of weeks, but the tiredness can be much more stubborn and may linger for several weeks or occasionally a few months after everything else has settled. This lasting fatigue is a normal part of the illness and not a sign that something is wrong. Recovery is helped by rest, fluids and a gradual return to normal activity rather than pushing too hard too soon; some people need a phased return to school, work or training. If the fatigue is not slowly improving over time, or is severely affecting daily life, it is worth seeking advice.
Sources
Where this is drawn from
- NICE CKS: Glandular fever (infectious mononucleosis).
- UK Health Security Agency: Epstein-Barr virus and glandular fever.
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