RSV Treatment Options for Adults: What You Need to Know for RSV Season

Respiratory syncytial virus (RSV) is a common cold virus that’s active during the winter months. Young children and babies are more likely to develop severe RSV illness, but adults can get RSV, too.

Adults who get RSV can come down with mild cold symptoms or more serious lower respiratory tract infections, like pneumonia and bronchitis. 

There’s no cure for RSV, but there are treatment options that can lessen symptoms. 

What are the symptoms of RSV in adults?

RSV symptoms in adults can range from mild to severe. Most adults who get RSV develop an upper respiratory tract infection. This means they experience symptoms of the common cold, such as:

• Congestion

• Runny nose

• Lower energy

• Cough

But some adults develop lower respiratory tract infections, which means the virus attacks the airways and lungs. This leads to more serious RSV illness, and adults experience symptoms like:

• Difficulty breathing

• Wheezing

• Fever

• Trouble keeping down fluids

Adults with severe RSV illness often need care in a hospital where they can receive breathing support. 

Treatment options for adults with mild RSV

There are some treatment options for mild RSV that can help ease your symptoms. But keep in mind that they won’t cure your RSV infection — only your immune system can do that. 

RSV is very contagious. So, to keep others safe, stay home as much as possible and avoid contact with people at high risk for serious RSV illness until you’re completely recovered. 

EXPERT PICKS: WHAT TO READ NEXT

• How long are you contagious with RSV? If you come down with respiratory syncytial virus (RSV), you’ll likely be contagious for 3 to 8 days. Here’s how to limit the spread of RSV.

• Can RSV turn into pneumonia? RSV often causes the common cold, but it can also lead to more serious illnesses, like pneumonia. Learn how to prevent RSV complications.

• Can you get RSV twice? Yes, it’s actually quite common to get RSV multiple times in your life. Some even get RSV twice in the same year.

High-risk groups include:

• Babies

• Children younger than 2 years 

• Adults older than 65 years 

• Anyone with a weakened immune system

While you’re recovering, here are some RSV treatments that can relieve your symptoms. 

Nasal saline

RSV is notorious for causing nasal congestion and runny nose. The virus increases mucus production along the respiratory system. Nasal saline helps clear these secretions so that you can breathe easier and keep your sinuses clear. 

You can use a neti pot with saline or opt for nasal saline spray. You can use nasal saline whenever you feel congested. There’s no limit to how much you can use each day. Just make sure you only use sterile saline. Don’t put tap water into your nose, as this can lead to serious infections. 

Over-the-counter fever and pain relievers

Over-the-counter (OTC) fever and pain relievers like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can relieve fevers and body aches.

There’s no evidence that one works better than the other for RSV-related symptoms. If you have certain medical conditions or take certain medications, one may be safer for you than another. Ask your primary care provider which is better for you. Start with the lowest recommended dose, and follow the instructions about how much you can safely take per day.

Honey

Researchers are finding more evidence that honey can help soothe sore throats and relieve cough. You can take a spoonful of honey whenever you feel like you need to soothe your throat. You can also take some throughout the day to keep a cough at bay. 

Mixing honey with tea can also be effective. If you have diabetes, make sure to talk with your healthcare team about how getting extra sugar can affect your care plan.

Cough and cold medications

There are a lot of OTC cough and cold medications. Decongestants can relieve stuffiness, and cough suppressants can temporarily lessen a cough. Always follow the dosage directions to avoid side effects like rebound congestion. 

If you take any long-term medications, talk with a healthcare professional before you start taking cough and cold medications. Some OTC options can interfere with prescription medications. 

Fluids

Staying hydrated is even more important when you’re sick because it helps your immune system work at its best. Plus hydration helps thin out mucus so it’s easier to cough up. 

Drink plenty of fluids throughout the day. A good rule of thumb is to make sure you drink enough so that you pee at least every 6 hours. Your urine should be pale yellow to clear. 

How do you treat severe RSV illness?

People older than 65 years and those with chronic medical conditions or weakened immune systems are at risk for developing serious RSV illness. 

If you’re at risk for severe RSV illness, see a healthcare professional as soon as you start feeling sick — even if you only have mild symptoms. They may recommend additional medications to keep your symptoms from getting worse.

Here are some common treatments for adults with severe RSV.

Oxygen

RSV causes lung inflammation that can interfere with how the body carries oxygen from the lungs into the blood. This leads to low oxygen levels in the body. And this is dangerous for all of your organs. 

To overcome this inflammation, you may need extra oxygen. Oxygen is a medication. So, if you need it, you’ll likely be admitted to a hospital, even if you already use oxygen at home. 

When you breathe in extra oxygen, more of it has a chance of getting through and into your blood. Some people can breathe oxygen through a mask. Others need extra help from machines, like CPAP, that help push oxygen into the lungs. Sometimes adults who are very ill with RSV need help breathing with a ventilator.

Bronchodilators

Inflammation from RSV can also make the airways spasm. Bronchodilators are medications that relax the airways so that oxygen can get through to the lungs more easily. 

Albuterol can help ease RSV symptoms if you have asthma or chronic obstructive pulmonary disease (COPD). If you already take this medication, your primary care provider may recommend taking higher doses more frequently to help your symptoms. If RSV worsens your asthma or COPD, you may need treatment with bronchodilators in a hospital. 

Right now, it’s not clear if albuterol is helpful if you don’t have an underlying lung condition. If you have serious RSV illness, a healthcare professional may recommend that you try the medication to see if it helps you. 

Steroids

If you have a history of asthma, your primary care provider may ask you to start taking oral steroids like prednisone. This can help calm inflammation in the lungs and prevent an asthma attack. 

Steroids don’t seem to help if you don’t have a history of asthma. However, if you have serious RSV illness, and especially if you’re in the hospital, a healthcare professional may ask you to take steroids to see if they help improve your symptoms.

Antibiotics  

Antibiotics only treat bacterial infections, not viral ones like RSV. But sometimes viruses overwhelm the immune system, and bacteria can take advantage to cause an infection. 

When people have RSV, they can develop a bacterial pneumonia on top of their RSV illness. In these situations, antibiotics can cure pneumonia — but they won’t help fight off RSV. 

Ribavirin

Ribavirin is an FDA-approved antiviral medication. It comes as a pill or as an inhaled medication. There’s some evidence that ribavirin can lower the risk of serious complications in people who are immunocompromised and have severe RSV illness. The medication is mostly saved for people who’ve had recent stem cell and solid organ transplants. 

Intravenous immunoglobulins (IVIG)

Intravenous immunoglobulins (IVIG) is a medication made up of antibodies that may be able to neutralize RSV. Like ribavirin, IVIG is saved for people who get very sick with RSV. It can be given with ribavirin. 

None of these options are perfect, so it’s important to take steps to avoid getting sick with RSV:

• Stay away from people who are sick with RSV or cold symptoms.

• Wash your hands frequently.

• Wear a mask in public places.

If you’re older than 60 years, you may also qualify for an RSV vaccine. Arexvy is an FDA-approved vaccine that protects against severe RSV illness. In clinical trials, Arexvy lowered the risk of severe RSV illness by 94%. 

What are the potential complications of RSV in adults?

Adults with more severe RSV illness can develop serious complications, like:

• Pneumonia

• Bronchitis

• Dehydration

• Worsening of COPD, asthma, or other lung conditions

• Worsening of congestive heart failure or other heart conditions

• Respiratory failure

Adults can become very sick from RSV, especially if they’re older or have a weakened immune system. There’s some evidence that RSV causes almost as much serious illness as the seasonal flu. And the CDC estimates that between 6,000 and 10,000 older adults die each year due to RSV infection.

How can you reduce your risk of getting RSV?

Even if you have only mild RSV illness, you’ll want to avoid getting it again. It’s possible to get RSV several times. To avoid getting RSV yourself and to keep others safe:

• Try not to touch your face, eyes, and mouth unless you’ve first washed your hands with soap and water. 

• Keep your distance from people who have cold-like symptoms. Remember that babies and young children are more likely to get RSV.

• Consider wearing a mask when you’re in public spaces during cold and flu season.

• Talk with a healthcare professional to see if you’re eligible for an RSV vaccine. Vaccination is available for some pregnant women, babies, and older adults. 

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Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician in a variety of clinical settings. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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