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Afflictions, Poisons & Diseases

Wherever there is life, there are insidious perils that threaten the health and well-being of living creatures. Some of these afflictions, including many diseases, are inherent to the natural world. Others, such as drugs, are crafted by people the world over for recreational, unscrupulous, or other uses. and some—curses being the most notorious—exist solely to cause harm to others.

Afflictions strike creatures with potent and often escalating results. This section presents a variety of curses, diseases, and drugs for use in your game.

Depending on the tone of the campaign, the GM might want to roll secret saving throws for PCs affected by an affliction. This is particularly effective when the affliction is an element within a survival or horror game, or when it’s part of a mystery.

Contents

Curses

A curse is a manifestation of potent ill will. Curses typically have a single effect that takes place upon a failed saving throw and lasts a specified amount of time, or can be removed only by certain actions a character must perform or conditions they must meet. Rarely, curses will have stages; these follow the rules for afflictions.

Curses may come from a malicious action, such as a lich’s Paralyzing Touch or a spell from an evil spellcaster.

Guardians of a tomb or treasure might ward their charge with a curse as protection against thieves. In some rare cases, a curse might manifest as a response to a terrible act, such as a massacre. When using a curse in your game, assign the curse to an item, location, situation, or similar element.

Then, decide on a trigger for the curse—such as a creature attempting to steal a warded book, destroy a work of art, or slay a specific creature. A curse can even be tied to a specific location, in which case it functions as a simple hazard. Once that trigger occurs, the curse affects the triggering creature or creatures. Each affected creature must attempt a saving throw against the curse; if they fail, they are subject to the effects specified in the curse’s Effect entry.

Curse of Nightmares Curse 2

Source GMG

Curse Illusion Magical Mental

This curse plagues you with terrible nightmares whenever you sleep, preventing you from resting properly.


Saving Throw DC 16 Will; Effect You must rest for 12 hours instead of 8 to avoid becoming fatigued and can’t gain any benefits from resting or long-term rest. You can still make your daily preparations.

Theft of Thought Curse 3

Source GMG

Curse Enchantment Magical Mental

This curse protects a single book and activates against any creature who Steals it.


Saving Throw DC 18 Will; Effect You begin to lose details from your memories, as well as a portion of your procedural memory. After being cursed, the first time you attempt a check using a skill in which you are trained or better, your proficiency rank in the skill used decreases by one rank for as long as you are cursed.

Slayer’s Haunt Curse 4

Source GMG

Curse Illusion Magical Visual

You are haunted by all those you have killed.


Saving Throw DC 19 Will; Effect You see all creatures around you as those you have slain, still bearing their wounds.

You can’t identify, Recall Knowledge about, or otherwise interact with these creatures in any way that involves seeing their true form without first succeeding at a Will save against the curse’s DC to see through the illusion.

On a critical failure for such a Will save, you become frightened 1.

Coward’s Roots Curse 5

Source GMG

Curse Enchantment Fear Magical Mental

You find all courage stolen from your heart. When faced with something frightening, you flee in terror or stand frozen in place.


Saving Throw DC 20 Will; Effect At the start of your turn, if you are frightened, you become your choice of immobilized or fleeing until the end of that turn.

Curse of the Ravenous Curse 5

Source GMG

Curse Magical Transmutation

This hideous curse kills through constant hunger.

You become gaunt and repeatedly gnash your teeth.


Saving Throw DC 20 Fortitude; Effect No matter how much you eat, you aren’t satiated. After 1 day, you begin starving. Each week, you receive a new saving throw against the curse.

Wizard’s Ward Curse 6

Source GMG

Abjuration Curse Magical

A wizard’s ward is placed upon a single book, usually a spellbook. If you damage the book, you must attempt a save against the curse’s effect.


Saving Throw DC 22 Will; Effect You take 5d6 damage of the same damage type as the damage you dealt to the book, and the damage can’t be healed as long as the curse lasts.

Repairing the book, including replacing any missing text, ends this curse.

Oath of the Flesh Curse 7

Source GMG

Abjuration Curse Magical

When you swear an oath, you must obey that oath or suffer terrible consequences.


Saving Throw DC 23 Fortitude; Effect Each time you make a promise to someone, an ornate symbol representing that promise is magically carved into your flesh. Breaking any of these promises causes the symbol tattoo to grow into a gaping wound, dealing 3d6 slashing damage to you; damage from the curse can’t be healed as long as the curse is still in effect.

Sellsword’s Folly Curse 9

Source GMG

Curse Emotion Enchantment Magical Mental

Even the most experienced combat veteran becomes as reckless as a rookie when suffering from sellsword’s folly.


Saving Throw DC 26 Will; Effect The chaos of combat overwhelms you. Each time you roll initiative for a combat encounter, you must attempt a new saving throw against the curse; on a failure, you become confused for 1 round.

This is an incapacitation effect.

Curse of Slumber Curse 11

Source GMG

Curse Incapacitation Magical Necromancy Sleep

This legendary curse sends you into a sleep indistinguishable from death.


Saving Throw DC 28 Fortitude; Effect You fall asleep for 1 round (or permanently on a critical failure) and seem to be dead; a creature must succeed at a DC 30 Medicine check to realize you are alive. Noise doesn’t awaken you, but taking damage gives you a new saving throw against the curse.

Reviling Earth Curse 12

Source GMG

Curse Death Magical Necromancy

A reviling earth curse usually appears across a specific geographical region, such as a ruined town, a necromancer’s domain, or a similar area.


Saving Throw DC 30 Fortitude; Effect When you enter the area, you become doomed 1, or doomed 2 on a critical failure.

Spirit Anchor Curse 13

Source GMG

Curse Magical Necromancy Negative

This curse prevents your soul from moving on after death.


Saving Throw DC 31 Fortitude; Effect If you die while affected, your spirit is anchored to the Material Plane, and you become a ghost or other incorporeal undead.

Unending Thirst Curse 15

Source GMG

Curse Magical Transmutation

This curse kills through dehydration in the same vein as the curse of the ravenous, but with deadly speed.


Saving Throw DC 32 Fortitude; Effect You gain no benefit from drinking water or other liquids and begin suffering from thirst. Each day, you receive a new saving throw against the curse.

Reviled of Nature Curse 18

Source GMG

Curse Emotion Enchantment Magical Mental

This curse makes the hunter into the hunted, drawing the ire of animals wherever you go.


Saving Throw DC 38 Will; Effect Creatures of the natural world abhor you. Whenever an animal becomes aware of you, it must attempt a Will save against the curse. On a failure, it attacks you and fights to the death.

Thief’s Retribution Curse 19

Source GMG

Conjuration Curse Magical

This punishment causes you to lose something dear to you whenever you rob or steal. If you have nothing to lose, the curse exacts its punishment upon your body instead.


Saving Throw DC 39 Fortitude; Effect Each time you steal something, you lose something more valuable—this item is whisked away and can’t be found again. Typically this item is one of greater monetary value, but it might be one of greater value in another sense, such as one of greater emotional value, or something you need to complete a task. If you aren’t carrying anything of greater value at the time of the theft, you lose one of your limbs instead, taking 10d6 slashing damage and losing use of that limb.

The damage can’t be healed, nor the limb restored, until the stolen item is returned, even through use of spells like regenerate.

Sword of Anathema Curse 20

Source GMG

Curse Divine Evocation

With divine intervention, followers of a deity can bestow this curse upon an enemy of the faith.


Saving Throw DC 40 Will; Effect You are marked by the deity invoked as an enemy of the church.

You gain weakness 10 to damage dealt by worshipers of that deity.

Grave Curse Curse Varies

Source GMG

Curse Necromancy Magical

A grave curse punishes you for stealing from a tomb or other resting place.


Saving Throw Will save, with a high spell DC for a monster of its level; Effect You are hounded by undead creatures of the same level as the curse. Every night, you must attempt a DC 15 flat check. On a failure, an incorporeal undead manifests to hassle and harry you throughout the night, retreating before it can take much damage and often preventing you from gaining a full night’s rest. Whenever you enter a graveyard or other area where bodies are buried, you must succeed at the same flat check or a body animates as a corporeal undead (typically a skeleton or zombie) to attack you.

These undead are temporary and exist only to harry you; if you take control of the undead, move on, or otherwise avoid their attacks, incorporeal undead discorporate and corporeal undead collapse into ordinary corpses. The curse can be removed by returning the stolen items to their resting place.

Diseases

Exposure to disease can be a hazard, such as when PCs come into contact with a plague-ridden corpse; such hazards grant XP as a simple hazard of the disease’s level. When a disease gives a sickened condition that can’t be reduced until it runs its course, that typically means the disease has symptoms such as a difficulty swallowing, loss of appetite, or nausea that make eating and drinking difficult but not impossible. Despite the condition’s prohibition on eating or drinking, a creature can slowly and carefully eat and drink as long as they aren’t in an encounter.

Addiction Disease Varies

Source GMG

Track The maximum stage you reach with each drug’s addiction. This maximum stage is separate from your current addiction stage for the drug. The maximum stage can’t be reduced, even if you fully remove the disease. When you take the drug, two things happen: you attempt a saving throw against addiction, and you suppress the effects of addiction for 1 day. Failing a save against addiction caused by taking the drug causes you to go to 1 stage higher than the maximum stage you had previously reached (2 stages higher on a critical failure). If you’re currently suffering from addiction when you attempt a save from taking the drug, you can’t improve your stage; if you succeed at the save, the stage remains the same as it was.

When you attempt your save against addiction each week, the stage you are currently at can’t get worse—it can only stay the same or improve. The conditions from addiction can’t be removed while you are affected by the addiction, and suppressing addiction by taking the drug only avoids the effects—it doesn’t remove the disease.


Saving Throw Fortitude (DC equals that of the drug); Onset 1 day; Stage 1 fatigued (1 week); Stage 2 fatigued and sickened 1 (1 week); Stage 3 fatigued, drained 1, and sickened 1 (1 week); Stage 4 fatigued, drained 2, sickened 2, and stupefied 2 (1 week)

Bog Rot Disease 0

Source GMG

Disease

Sometimes called bog foot, bog rot is caused by having waterlogged feet for an extended period of time. In addition to the usual cures for an affliction, bog rot can be cured through amputation of the affected appendages.


Saving Throw DC 13 Fortitude; Onset 1 day; Stage 1 clumsy 1 (1 day); Stage 2 clumsy 1 and a –5-foot status penalty to Speed (1 day); Stage 3 clumsy 2 and a –10-foot status penalty to Speed (1 day)

Scarlet Fever Disease 1

Source GMG

Disease

The relatively simple sore throat caused by this disease leads many victims to initially dismiss it as a mild illness, but scarlet fever can be deadly if left untreated.

You can’t reduce your sickened condition while affected with scarlet fever.


Saving Throw DC 13 Fortitude; Onset 2 days; Stage 1 sickened 1 (1 day); Stage 2 sickened 2 (1 day); Stage 3 sickened 3 and can’t speak (1 day); Stage 4 death

Tetanus Disease 1

Source GMG

Disease

An infection introduced through open wounds, tetanus can produce stiffness, muscle spasms strong enough to break bones, and ultimately death.


Saving Throw DC 14 Fortitude; Onset 10 days; Stage 1 clumsy 1 (1 week); Stage 2 clumsy 2 and can’t speak (1 day); Stage 3 paralyzed with spasms (1 day); Stage 4 death

Tuberculosis Disease 1

Source GMG

Disease

An extended respiratory disease, tuberculosis can pose particular challenges to spellcasters and some performers due to the intense coughing fits it produces.


Saving Throw DC 15 Fortitude; Onset 1 week; Stage 1 carrier with no effects (1 week); Stage 2 coughing requires you to succeed at a DC 5 flat check to Cast a Spell with a verbal component or Activate an Item with a command component (1 week); Stage 3 fatigued, can’t recover from the fatigued condition, and coughing requires a successful DC 15 flat check to Cast a Spell with a verbal component or Activate an Item with a command component (1 week); Stage 4 unconscious (1 week); Stage 5 death

Malaria Disease 2

Source GMG

Disease

A pernicious disease spread by bloodsucking insects, malaria sometimes enters long periods of dormancy. If you succumb to malaria, you may continue to be periodically affected by the disease, even if you’re cured.

You can’t reduce your sickened condition while affected with malaria.


Saving Throw DC 16 Fortitude; Onset 10 days; Stage 1 sickened 1 (1 day); Stage 2 sickened 2 (1 day); Stage 3 sickened 2, and disease recurs every 1d4 months even if cured (1 day); Stage 4 unconscious (1 day); Stage 5 death

Bubonic Plague Disease 3

Source GMG

Disease

This widespread illness can sweep through entire communities, leaving few unaffected. The first indication of the disease is a telltale swelling of glands. In some cases, the disease can move into your lungs (pneumonic plague) or blood (septicemic plague), which is even more fatal. If you have bubonic plague, you can’t remove the fatigued condition while affected.


Saving Throw DC 17 Fortitude; Onset 1 day; Stage 1 fatigued (1 day); Stage 2 enfeebled 2 and fatigued (1 day); Stage 3 enfeebled 3, fatigued, and take 1d6 persistent bleed damage every 1d20 minutes (1 day)

Scarlet Leprosy Disease 4

Source GMG

Disease Virulent

Scarlet leprosy is widely feared for its devastating effects, crushing bones and organs while making recovery nearly impossible. Damage taken from scarlet leprosy can’t be healed until the disease is cured.


Saving Throw DC 19 Fortitude; Onset 1 day; Stage 1 2d6 bludgeoning damage (1 day); Stage 2 2d6 bludgeoning damage, and whenever you gain the wounded condition, increase the condition value by 1 (1 day); Stage 3 4d6 bludgeoning damage and can’t heal any Hit Point damage (1 day)

Bonechill Disease 5

Source GMG

Disease Necromancy Primal

If you are wounded and exposed to persistent cold, you might contract bonechill.


Saving Throw DC 20 Fortitude; Onset 1 day; Stage 1 clumsy 1 (1 day); Stage 2 clumsy 2 and can’t heal cold damage until this disease is cured (1 day); Stage 3 clumsy 3 and all cold temperature effects are one step more severe for the victim (1 day); Stage 4 paralyzed and all cold temperature effects are one step more severe for the victim (1 day)

Choking Death Disease 6

Source GMG

Disease

This disease is capable of wiping out nations or even entire continents. A few pockets of the disease still remain in limited areas, keeping that region’s population sparse.


Saving Throw DC 22 Fortitude; Onset 1 day; Stage 1 hoarse voice but no other symptoms (1 day); Stage 2 drained 1 (1 day); Stage 3 drained 2 and can’t speak (1 day); Stage 4 death

Blinding Sickness Disease 7

Source GMG

Disease

Endemic to jungles, blinding sickness is transmitted by dirty water or the bites of certain creatures.


Saving Throw DC 23 Fortitude; Stage 1 carrier with no effects (1 day); Stage 2 enfeebled 1 (1 day); Stage 3 enfeebled 2 (1 day); Stage 4 enfeebled 2 and permanently blinded (1 day); Stage 5 enfeebled 4 (1 day); Stage 5 unconscious (1 day); Stage 6 death

Sewer Haze Disease 7

Source GMG

Disease Virulent

Many healers and alchemists suspect that sewer haze has a supernatural origin, given its association with particularly strong otyughs.


Saving Throw DC 23 Fortitude; Onset 2 days; Stage 1 stupefied 2 (1 day); Stage 2 drained 2 and stupefied 2 (1 day); Stage 3 drained 3 and stupefied 3 (1 day)

Nightmare Fever Disease 8

Source GMG

Disease Necromancy Occult

Thought to be caused by a night hag’s curse, nightmare fever inflicts you with terrible nightmares, and you awaken with the wounds you received in your dreams. Some versions cause you to dream of being wounded by bludgeoning or piercing weapons, in which case you take that type of damage instead.

Damage and the fatigued condition caused by the disease can’t be healed until the disease is removed.


Saving Throw DC 25 Will; Stage 1 2d6 slashing damage and fatigued (1 day); Stage 2 4d6 slashing damage and fatigued (1 day); Stage 3 4d6 slashing damage, fatigued, and whenever you take slashing damage, you must succeed at a Will save against the disease’s DC or become frightened 2 (1 day); Stage 4 6d6 slashing damage, fatigued, and whenever you take slashing damage, you must succeed at a Will save against the disease’s DC or become paralyzed for 1 round (1 day); Stage 5 6d6 slashing damage and unconscious

Brain Worms Disease 11

Source GMG

Disease Virulent

Scholars suspect these brain parasites have an otherworldly or extraplanar origin. Though transmitted by the bites of infected targets, the disease remains relatively rare—most hosts are killed by the effects before they can pass it on. While infected, whenever you attack due to confusion, you bite your target (if you don’t have a jaws or fangs attack, you deal piercing damage as an unarmed attack with damage equal to your lowest unarmed attack).


Saving Throw DC 28 Fortitude; Onset 1 day; Stage 1 stupefied 2 (1 day); Stage 2 stupefied 2, and whenever you take damage, you must succeed at a Will save against the disease’s DC or become confused for 1 round (1 day); Stage 3 stupefied 3, and whenever you take damage, you must succeed at a Will save against the disease’s DC or become confused for 1 minute (1 day); Stage 4 stupefied 4 and confused, damage does not end the confused condition (1 day); Stage 5 unconscious (1 day); Stage 6 death

Crimson Ooze Disease 15

Source GMG

Disease Virulent

This devastating fungus infects your hand and can be cured by amputating the limb before you reach stage 4.


Saving Throw DC 34 Fortitude; Stage 1 clumsy 1 (1 day); Stage 2 clumsy 2, and using the infected hand deals 3d6 persistent bleed damage (1 day); Stage 3 clumsy 2, stupefied 2, and the infected hand is unusable (1 day); Stage 4 clumsy 3, stupefied 3, and infected hand is permanently unusable (1 day); Stage 5 confused, and damage does not end the confused condition (1 day); Stage 6 death

Abyssal Plague Disease 9

Sources of this hazard night hags

The target can’t recover from the drained condition from Abyssal plague until the disease is cured. Stage 1 drained 1 (1 day); Stage 2 drained increases by 2 (1 day).

  • Critical Success The target is unaffected.
  • Success The target takes 2 evil damage per spell level, and takes a –2 status penalty to saves against Abyssal plague for 1 day or until the target contracts it, whichever comes first.
  • Failure The target is afflicted with Abyssal plague at stage 1.
  • Critical Failure The target is afflicted with Abyssal plague at stage 2.

Avernal Fever Disease ?

Saving Throw DC 23 Fortitude; Stage 1 carrier with no ill effect (1 day); Stage 2 enfeebled 1 (1 day); Stage 3 enfeebled 2 (1 day)

Guano Fungus Level 3

Source PAP151

Contact Disease

Sources of this hazard giant bats, bats

Bats are immune to guano fungus. You can’t reduce your enfeebled condition until the disease is cured. Saving Throw DC 18 Fortitude; Stage 1 enfeebled 1 (1 day); Stage 2 enfeebled 2 (1 day); Stage 3 enfeebled 3, sickened 1, and you can’t reduce your sickened value below 1 (1 day); Stage 4 unconscious (1 day); Stage 5 dead

Cacodaemonia Disease ?

Sources of this hazard cacodaemons

A cacodaemon can telepathically communicate with the afflicted creature at any distance on the same plane


Saving Throw DC 17 Fortitude; Stage 1 carrier (1 day); Stage 2 stupefied 1 (1 day); Stage 3 stupefied 2 (1 day)

Daemonic Pestilence Disease ?

Sources of this hazard leukodaemons

A leukodaemon can telepathically communicate with the afflicted creature at any distance on the same plane


Saving Throw DC 28 Fortitude; Stage 1 carrier (1 day); Stage 2 drained 1 (1 day); Stage 3 drained 2 (1 day); Stage 4 drained 2 (1 day); Stage 5 drained 3 (1 week); Stage 6 dead

Filth Fever Disease ?

Sources of this hazard giant rats, otyughs

The sickened and unconscious conditions from filth fever don’t improve on their own until the disease is cured.; Saving Throw DC 14 Fortitude; Stage 1 carrier with no ill effect (1d4 hours), Stage 2 sickened 1 (1 day), Stage 3 sickened 1 and slowed 1 (1 day), Stage 4 unconscious (1 day), Stage 5 dead

Ghoul Fever Disease 3

Sources of this hazard ghouls, ghasts

Stage 1 carrier with no ill effects (1 day); Stage 2 3d8 negative damage and the creature regains half as many Hit Points from all healing (1 day); Stage 3 as stage 2 (1 day); Stage 4 3d8 negative damage and the creature gains no benefit from healing (1 day); Stage 5 as stage 4 (1 day); Stage 6 the creature dies and rises as a ghoul at the next midnight

  • Critical Success The target is unaffected.
  • Success The target is afflicted with ghoul fever at stage 1.
  • Failure The target is afflicted with ghoul fever at stage 2.
  • Critical Failure The target is afflicted with ghoul fever at stage 3.

Goblin Pox Disease 1

Sources of this hazard goblins, goblin dogs

Goblins and goblin dogs are immune. Stage 1 sickened 1 (1 round); Stage 2 sickened 1 and slowed 1 (1 round); Stage 3 sickened 1 and the creature can’t reduce its sickened value below 1 (1 day)

  • Critical Success The target is unaffected.
  • Success The target is sickened 1.
  • Failure The target is afflicted with goblin pox at stage 1.
  • Critical Failure The target is afflicted with goblin pox at stage 2.

Spore Blight Disease ?

Sources of this hazard terotricus

Plants and fungi are immune. Saving Throw Fortitude DC 40; Stage 1 enfeebled 2 (1 day); Stage 2 enfeebled 4 and slowed 1 (1 day); Stage 3 controlled by the terotricus (as dominate; 5d8 days); Stage 4 dead.

Wasp Larva Disease ?

Sources of this hazard giant wasps


Saving Throw Fortitude DC 21; Stage 1 carrier with no ill effect (1d6 days); Stage 2 drained 1 (1d3 days); Stage 3 5d6 damage, larva emerges (disease ends)

Wretched Weeps Disease ?

Sources of this hazard ofalth


Saving Throw DC 26 Fortitude; Stage 1 carrier with no ill effect (1 day); Stage 2 2d8 persistent bleed damage every hour and enfeebled 1 (1 day); Stage 3 2d8 persistent bleed damage every hour and enfeebled 2 (1 day)

Drugs

Drugs offer short-term benefits with harmful side effects and long-term consequences. These short-term benefits, such as euphoria, draw many to drugs, but addiction keeps users hooked long after their first dose. A character can voluntarily fail their initial save against a drug, but for each dose they consume, they must attempt a saving throw against addiction, a disease that represents cravings and withdrawal. Addiction is unique to each drug, so a character can be affected by multiple instances of addiction at once.

Certain drugs alter how addiction works for that drug, adding the virulent trait to the addiction, limiting the maximum stage a character can reach, or adding additional stages beyond those listed in the base affliction.

Drugs In Your Game

Drugs are socially complex, and including them in your game has the potential to make some of your players uncomfortable—particularly players who have struggled with substance abuse themselves or seen friends and family members go through that struggle. As with any potentially difficult subject matter, you should discuss the role drugs play in your game with your players and ensure that all the players at the table are comfortable with the material; if they aren’t, avoid the topic.

If you do include drugs in your game, consider the role they’ll play. In some campaigns, drugs might simply be an element of flavor and a tool characters use to reach their goals; in others, the side effects and risk of addiction might be a terrible price to pay. The rules assume something of a middle path, where drugs are addictive substances that may provide a short-term benefit but have consequences. To make drugs more accessible in your game, remove some of the more severe stages of addiction. To make them more dangerous, add the virulent trait to the addiction affliction, add more stages with increasingly severe effects, or increase the DC of the save against the addiction by 1 for every use of the drug, decreasing back to normal over time as they stop using the drug.

Alcohol Item 0

Source GMG

Alchemical Consumable Drug Ingested Poison

Price 1 cp or more Usage held in 1 hand; Bulk L

Activate [one-action] Interact Alcohol is a common substance available in stunning variety.

The Price of a dose of alcohol depends on the specific beverage.

You can’t recover from the sickened condition from alcohol while affected.

If you fail a saving throw against alcohol other than initial saves, the affliction’s stage doesn’t increase; the only way to increase the stage of alcohol’s affliction is to consume more alcohol.


Saving Throw DC 12 Fortitude; Onset 10 minutes; Stage 1 +1 item bonus to saving throws against fear effects (10 minutes); Stage 2 flat-footed, +1 item bonus to saving throws against fear effects (10 minutes); Stage 3 clumsy 1, flat-footed, stupefied 2 (10 minutes); Stage 4 clumsy 2 and sickened 2 (10 minutes); Stage 5 clumsy 2, sickened 2, and stupefied 2 (10 minutes); Stage 6 unconscious (8 hours); Stage 7 death

Bloodeye Coffee Item 0

Source GMG

Alchemical Consumable Drug Ingested Poison

Price 5 sp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact A strong blend including several spices, bloodeye coffee is a favorite morning drink. The maximum addiction stage of bloodeye coffee never progresses beyond stage 1.


Saving Throw DC 14 Fortitude; Onset 10 minutes; Maximum Duration 8 hours; Stage 1 +1 item bonus to AC and saves to which you are taking penalties caused by the fatigued condition (10 minutes); Stage 2 stupefied 1 (1 hour); Stage 3 can’t recover from fatigued (1 day, after which the drug ends)

Flayleaf Item 0

Source GMG

Alchemical Consumable Drug Ingested Inhaled Poison

Price 1 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact

The flayleaf plant is relatively common, though the mildly euphoric effects of smoking its dried leaves increase when it’s sourced from plants specifically grown to produce such effects.


Saving Throw DC 12 Fortitude; Onset 10 minutes; Maximum Duration 4 hours; Stage 1 +1 item bonus to saving throws against mental effects (1 hour); Stage 2 fatigued and +1 item bonus to saving throws against mental effects (1 hour); Stage 3 fatigued and stupefied 1 (1 hour); Stage 4 fatigued, frightened 2, stupefied 2 (1 hour)

Blood Sap Item 1

Source GMG

Alchemical Consumable Drug Ingested Poison

Price 4 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact

This potent drug is distilled from a certain tropical vine into a deep-red syrup that, over time, stains the user’s lips and teeth a vivid shade of red.


Saving Throw DC 16 Fortitude; Onset 10 minutes; Maximum Duration 3 hours; Stage 1 drained 1, +1 item bonus to weapon and unarmed attack rolls, Acrobatics checks, and Athletics checks (10 minutes); Stage 2 slowed 1 (1 hour)

Refined Pesh Item 1

Source GMG

Alchemical Consumable Drug Ingested Inhaled Poison

Price 2 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact When eaten or smoked, pesh gives users a sense of well-being, sometimes with hallucinations, aggression, and exhaustion.


Saving Throw DC 12 Fortitude; Onset 1 minute; Maximum Duration 6 hours; Stage 1 stupefied 1 and a +2 item bonus to saves versus fear effects (1 minute); Stage 2 1 temporary Hit Point per level (first time you reach this stage only), +2 item bonus to saves versus fear effects, clumsy 1, and stupefied 1 (1 minute); Stage 3 clumsy 2 and stupefied 2 (1 hour)

Shiver Item 3

Source GMG

Alchemical Consumable Drug Ingested Poison

Price 10 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact A compound produced from the hallucinogenic venom of certain spiders, shiver is common in black markets.

The addiction to shiver has the virulent trait.


Saving Throw DC 19 Fortitude; Maximum Duration 4 hours; Stage 1 whenever you become frightened, reduce that condition’s value by 1 (10 minutes); Stage 2 clumsy 2 (1 hour); Stage 3 asleep (1 hour)

Dreamtime Tea Item 4

Source GMG

Alchemical Consumable Drug Ingested Poison

Price 13 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact

This lemony tea blended from rare herbs and flowers is widely circulated by occult circles looking to transcend the boundaries of reality. The saving throw for addiction to dreamtime tea is DC 19.


Saving Throw DC 21 Fortitude; Maximum Duration 30 minutes; Stage 1 stupefied 2 (1 minute); Stage 2 unconscious and can ask a question with the effects of augury except the flat check DC is 10 (10 minutes)

Zerk Item 4

Source GMG

Alchemical Consumable Drug Injury Poison

Price 20 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact

This bitter paste is used among some gladiatorial rings for its short-term benefits in a fight.


Saving Throw DC 20 Fortitude; Maximum Duration 1 hour; Stage 1 +2 item bonus to Perception rolls for initiative, and if you have an addiction to zerk, your melee weapon and unarmed attacks deal an extra 2 damage during the first round of a combat encounter (1 minute); Stage 2 drained 1 (1 hour)

Cytillesh Item 5

Source GMG

Uncommon Alchemical Consumable Drug Ingested Poison

Price 30 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact Deros use cytillesh in a variety of ways, and some surface-dwellers seek out the fungus for their own use. Memories lost to cytillesh can be restored through modify memory. The save for addiction to cytillesh is DC 20, and the addiction has the virulent trait.


Saving Throw DC 15 Fortitude; Maximum Duration 8 hours; Stage 1 stupefied 1 (1 minute); Stage 2 lose all memories made in the previous hour (1 hour)

Elven Absinthe Item 5

Source GMG

Alchemical Consumable Drug Ingested Poison

Price 25 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact


Saving Throw DC 20 Fortitude; Onset 1 hour; Maximum Duration 1 day; Stage 1 +2 item bonus to Diplomacy and Performance checks (1 hour); Stage 2 drained 2 (1 hour); Stage 3 stupefied 4 (1 hour)

Scour Item 8

Source GMG

Uncommon Alchemical Consumable Drug Ingested Inhaled Poison

Price 80 gp; Usage held in 1 hand; Bulk L

Activate [one-action] Interact

This gritty powder improves responsiveness but suppresses thoughts and leaves you weakened. The saving throw for addiction to scour is DC 30, and the addiction is virulent.


Saving Throw DC 25 Fortitude; Onset 1 hour; Maximum Duration 6 hours; Stage 1 stupefied 2 and +2 item bonus to Reflex saves and Dexterity-based skill checks (1 hour); Stage 2 fatigued (1 hour); Stage 3 drained 2 and fatigued (1 hour)

Poisons

Arsenic Item 1

Alchemical Consumable Ingested Poison

Price 3 gp; Usage held in 1 hand; Bulk L


This toxin is a compound of arsenic and other substances. You can’t reduce your sickened condition while affected.


Saving Throw DC 18 FortitudeOnset 10 minutes; Maximum Duration 5 minutes; Stage 1 1d4 poison damage and sickened 1 (1 minute); Stage 2 1d6 poison damage and sickened 2 (1 minute); Stage 3 2d6 poison damage and sickened 3 (1 minute)
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Belladonna Item 2

Alchemical Consumable Ingested Poison

Price 5 gp; Usage held in 1 hand; Bulk L


Sometimes called “deadly nightshade,” belladonna is a widely available toxin produced from a plant similar to a tomato.


Saving Throw DC 19 FortitudeOnset 10 minutes; Maximum Duration 30 minutes; Stage 1 dazzled (10 minutes); Stage 2 1d6 poison damage and sickened 1 (10 minutes); Stage 3 1d6 poison damage, confused, and sickened 1 (1 minute)
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Black Adder Venom Item 2

Alchemical Consumable Injury Poison

Price 6 gp; Usage held in 2 hands; Bulk L


Adder venom is a simple but effective way to enhance a weapon.


Saving Throw DC 18 FortitudeMaximum Duration 3 rounds; Stage 1 1d8 poison damage (1 round); Stage 2 1d10 poison damage (1 round); Stage 3 2d6 poison damage (1 round)
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Black Lotus Extract Item 19

Alchemical Consumable Contact Poison Virulent

Price 6,500 gp; Usage held in 1 hand; Bulk L


Black lotus extract causes severe internal bleeding.


Saving Throw DC 42 FortitudeOnset 1 minute; Maximum Duration 6 rounds; Stage 1 15d6 poison damage and drained 1 (1 round); Stage 2 17d6 poison damage and drained 1 (1 round); Stage 3 20d6 poison damage and drained 2 (1 round)
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Black Smear Poison Item 2

Uncommon Alchemical Consumable Injury Poison

Price 5 gp; Usage held, 2 hands; Bulk L


Many calignis use a debilitating poison crafted from subterranean fungi.


Saving Throw DC 16 FortitudeMaximum Duration 6 rounds; Stage 1 1d6 poison and enfeebled 1 (1 round); Stage 2 As stage 1; Stage 3 1d6 poison, and enfeebled 2 (1 round)
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Blightburn Resin Item 11

Alchemical Consumable Contact Poison

Price 225 gp; Usage held in 2 hands; Bulk L


This tacky, hardened sap is harvested from trees infected by fungal blights and exposed to open flames. 


Saving Throw DC 31 FortitudeOnset 1 minute; Maximum Duration 6 rounds; Stage 1 8d6 poison damage (1 round); Stage 2 10d6 poison damage (1 round); Stage 3 15d6 poison damage (1 round)
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Blue Dragonfly Poison Item 3

Uncommon Alchemical Consumable Ingested Poison

Price 7 gp; Usage held in 1 hand; Bulk L


Boggards brew a potent toxin made from blue dragonflies. Swampseers consume this mixture to awaken their divine powers, but the poison inspires crippling hallucinations in most other creatures.


Saving Throw DC 17 FortitudeOnset  10 minutes; Maximum Duration 30 minutes; Stage 1 dazzled (10 minutes); Stage 2 dazzled and frightened 1 (10 minutes); Stage 3 frightened 1 and confused 1 (1 minute)
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Brimstone Fumes Item 16

Alchemical Consumable Evil Inhaled Poison

Price 1,500 gp; Usage held in 1 hand; Bulk L


Fumes from the forges of Hell drain health and strength alike. 


Saving Throw DC 36 FortitudeOnset 1 round; Maximum Duration 6 rounds; Stage 1 7d6 poison damage and enfeebled 1 (1 round); Stage 2 8d6 poison damage and enfeebled 2 (1 round); Stage 3 10d6 poison damage and enfeebled 3 (1 round)
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Cytillesh Oil Item 3

Alchemical Consumable Injury Poison

Price 10 gp; Usage held in 2 hands; Bulk L


This thick substance is distilled from the mind-robbing cytillesh fungus, though it lacks memory-altering capabilities. 


Saving Throw DC 19 FortitudeMaximum Duration 4 rounds; Stage 1 1d10 poison damage (1 round); Stage 2 1d12 poison damage (1 round); Stage 32d10 poison damage (1 round)
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Deathcap Powder Item 13

Alchemical Consumable Ingested Poison

Price 450 gp; Usage held in 2 hands; Bulk L


The toxic deathcap mushroom can be dried, ground, and treated to form a flavorless powder with accelerated effects.


Saving Throw DC 33 FortitudeOnset 10 minutes; Maximum Duration 6 minutes; Stage 1 13d6 poison damage (1 minute); Stage 2 17d6 poison damage and sickened 2 (1 minute); Stage 3 20d6 poison damage and sickened 3 (1 minute)
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Dragon Bile Item 15

Alchemical Consumable Contact Poison

Price 925 gp; Usage held in 2 hands; Bulk L


A mix of digestive juices and green dragon poison glands nauseates the victim as its flesh is digested from within.


Saving Throw DC 37 FortitudeOnset 1 minute; Maximum Duration 6 rounds; Stage 1 6d6 poison damage and sickened 2 (1 round); Stage 2 7d6 poison damage and sickened 3 (1 round); Stage 3 9d6 poison damage and sickened 4 (1 round)
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Drider Venom

Saving Throw DC 23 Fortitude; Maximum Duration 6 rounds; Stage 1 1d8 poison damage and enfeebled 1 (1 round)

Ether Spider Venom (poison); Saving Throw DC 22 Fortitude; Maximum Duration 6 rounds; Stage 1 1d6 poison damage and clumsy 1 (1 round); Stage 2 2d6 poison damage, clumsy 2 and slowed 1 (1 round); Stage 3 3d6 poison damage, clumsy 3 and slowed 2 (1 round)

Giant Centipede Venom Item 1

Alchemical Consumable Injury Poison

Price 4 gp
Usage held in 2 hands; Bulk L


Giant centipede venom causes severe muscle stiffness.


Saving Throw DC 17 FortitudeMaximum Duration 6 rounds; Stage 1 1d6 poison damage (1 round); Stage 2 1d8 poison damage and flat-footed (1 round); Stage 3 1d12 poison damage, clumsy 1, and flat-footed (1 round)
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Giant Octopus Venom Item ?

Saving Throw DC 26 Fortitude; Maximum Duration 6 rounds; Stage 1 2d6 poison damage and flat-footed (1 round); Stage 2 2d6 poison damage, clumsy 1, and flat-footed (1 round); Stage 3 2d6 poison damage, clumsy 2, and flat-footed (1 round)

Giant Scorpion Venom Item 6

Alchemical Consumable Injury Poison

Price 40 gp; Usage held in 2 hands; Bulk L


Scorpion venom is excruciating and its effects are somewhat debilitating.


Saving Throw DC 22 FortitudeMaximum Duration 6 rounds; Stage 1 1d10 poison damage and enfeebled 1 (1 round); Stage 2 2d10 poison damage and enfeebled 1 (1 round); Stage 3 2d10 poison damage and enfeebled 2 (1 round)
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Giant Wasp Venom Item 7

Alchemical Consumable Injury Poison

Price 55 gp; Usage held in 2 hands; Bulk L


Giant wasp venom interferes with a victim’s movement. 


Saving Throw DC 25 FortitudeMaximum Duration 6 rounds; Stage 1 2d6 poison damage and clumsy 1 (1 round); Stage 2 3d6 poison damage and clumsy 2 (1 round); Stage 3 4d6 poison and clumsy 2 (1 round)
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Graveroot Item 3

Alchemical Consumable Injury Poison

Price 10 gp; Usage held in 2 hands; Bulk L


The opaque white sap from the graveroot shrub clouds the mind.


Saving Throw DC 19 FortitudeMaximum Duration 4 rounds; Stage 1 1d10 poison damage (1 round); Stage 2 1d12 poison damage and stupefied 1 (1 round); Stage 3 2d6 poison damage and stupefied 2 (1 round)
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Hemlock Item 17

Alchemical Consumable Ingested Poison

Price 2,250 gp; Usage held in 1 hand; Bulk L


Concentrated hemlock is a particularly deadly toxin that halts muscle action—including that of the victim’s heart.


Saving Throw DC 40 FortitudeOnset 30 minutes; Maximum Duration 60 minutes; Stage 1 17d6 poison damage and enfeebled 2 (10 minutes); Stage 221d6 poison damage and enfeebled 3 (10 minutes); Stage 3 26d6 poison damage and enfeebled 4 (10 minutes) 
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Hunting Spider Venom Item 5

Alchemical Consumable Injury Poison

Price 25 gp; Usage held in 2 hands; Bulk L


This venom erodes its target’s defenses, aiding the spider in securing prey.


Saving Throw DC 21 FortitudeMaximum Duration 6 rounds; Stage 1 1d10 poison damage and flat-footed (1 round); Stage 2 1d12 poison damage, clumsy 1, and flat-footed (1 round); Stage 3 2d6 poison damage, clumsy 2, and flat-footed (1 round)
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King’s Sleep Item 18

Alchemical Consumable Ingested Poison Virulent

Price 4,000 gp; Usage held in 1 hand; Bulk L


King’s sleep is an insidious long-term poison that can seem like a disease or even death from natural causes on a venerable target. The drained condition from king’s sleep is cumulative with each failed save and can’t be removed while the poison lasts.


Saving Throw DC 41 FortitudeOnset 1 day; Stage 1 drained 1 (1 day); Stage 2 drained 1 (1 day); Stage 3 drained 2 (1 day)
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Kraken Ink Item ?

Krakens are immune to this poison; Saving Throw DC 39 Fortitude; Maximum Duration 10 rounds; Stage 1 3d6 poison damage and sickened 1 (1 round); Stage 2 4d6 poison damage and sickened 2 (1 round).

Lethargy Poison Item 2

Uncommon Alchemical Consumable Incapacitation Injury Poison Sleep

Price 7 gp; Usage held in 2 hands; Bulk L


Lethargy poison is commonly used in hit-and-run tactics by drow and others who want their victims alive; the ambusher retreats until the poison sets in and the victim falls unconscious. Further exposure to lethargy poison does not require the target to attempt additional saving throws; only failing an saving throw against an ongoing exposure can progress its stage.


Saving Throw DC 18 FortitudeMaximum Duration 4 hours; Stage 1 slowed 1 (1 round); Stage 2 slowed 1 (1 minute); Stage 3 unconscious with no Perception check to wake up (1 round) Stage 4 unconscious with no Perception check to wake up (1d4 hours). 
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Lich Dust Item 9

Alchemical Consumable Ingested Poison

Price 110 gp; Usage held in 1 hand; Bulk L


Dust salvaged from the remains of a destroyed lich has paralytic properties that make it a valuable poison.


Saving Throw DC 28 FortitudeOnset 10 minutes; Maximum Duration 6 minutes; Stage 1 fatigued (1 minute); Stage 2 5d6 poison damage and fatigued (1 minute); Stage 3 5d6 poison damage, fatigued, and paralyzed (1 minute)
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Malyass Root Paste Item 7

Alchemical Consumable Contact Poison

Price 55 gp; Usage held in 2 hands; Bulk L


Malyass root paste sees use to impede opponents in athletic competitions, in addition to espionage and tracking.


Saving Throw DC 26 FortitudeOnset 1 minute; Maximum Duration 6 minutes; Stage 1 clumsy 1 and –10-foot status penalty to all Speeds (1 minute); Stage 2 clumsy 2 and –20-foot status penalty to all Speeds (1 minute); Stage 3 clumsy 3, flat-footed, and –30-foot status penalty to all Speeds
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Medusa Serpent Venom

Saving Throw DC 25 Fortitude; Maximum Duration 6 rounds; Stage 1 1d6 poison damage and enfeebled 1 (1 round); Stage 2 2d6 poison damage and enfeebled 2 (1 round)

Mindfog Mist Item 15

Alchemical Consumable Inhaled Poison

Price 1,000 gp; Usage held in 1 hand; Bulk L


Mindfog mist can be used to undermine spellcasters, as its effect on a victim’s mental faculties are swift and powerful.


Saving Throw DC 35 FortitudeOnset 1 round; Maximum Duration 6 rounds; Stage 1 stupefied 2 (1 round); Stage 2 confused and stupefied 3 (1 round); Stage 3 confused and stupefied 4 (1 round)
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Nettleweed Residue Item 8

Alchemical Consumable Contact Poison

Price 75 gp; Usage held in 2 hands; Bulk L


Concentrated sap of stinging weeds makes an effective toxin.


Saving Throw DC 27 FortitudeOnset 1 minute; Maximum Duration 6 minutes; Stage 1 8d6 poison damage (1 minute); Stage 2 10d6 poison damage (1 minute); Stage 3 13d6 poison damage (1 minute)
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Nightmare Vapor Item 16

Alchemical Consumable Inhaled Poison

Price 1,400 gp; Usage held in 1 hand; Bulk L


Purportedly sourced from any number of outlandish locales, nightmare vapor is most often created by boiling the sweat collected from humanoids caught in the throes of terrible nightmares.


Saving Throw DC 36 FortitudeOnset 1 round; Maximum Duration 6 rounds; Stage 1 confused (1 round); Stage 2 confused and flat-footed (1 round); Stage 3 confused, flat-footed, and stupefied 2 (1 round)
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Purple Worm Venom Item 13

Alchemical Consumable Injury Poison

Price 500 gp; Usage held in 2 hands; Bulk L


Venom from enormous purple worms leaves a victim weakened.


Saving Throw DC 32 FortitudeMaximum Duration 6 rounds; Stage 1 5d6 poison damage and enfeebled 2 (1 round); Stage 2 6d6 poison damage and enfeebled 2 (1 round); Stage 3 8d6 poison and enfeebled 2 (1 round)
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Reefclaw Venom

Saving Throw DC 17 Fortitude; Maximum Duration 4 rounds; Stage 1 1d6 poison damage and enfeebled 1 (1 round), Stage 2 1d6 poison damage and enfeebled 2 (1 round).

Shadow Essence Item 10

Alchemical Consumable Injury Negative Poison

Price 160 gp; Usage held in 2 hands; Bulk L


Distilled from the Plane of Shadow, this oily substance imposes tenebrous effects. The enfeebled condition from shadow essence lasts for 24 hours.


Saving Throw DC 29 FortitudeMaximum Duration 6 rounds; Stage 1 3d6 negative damage and 2d6 poison damage (1 round); Stage 2 3d6 negative damage, 2d6 poison damage, and enfeebled 1 (1 round); Stage 3 3d6 negative damage, 2d6 poison damage, and enfeebled 2 (1 round)
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Shuln Saliva (incapacitation, poison); Saving Throw DC 32 Fortitude; Maximum; Duration 6 rounds; Stage 1 2d6 poison damage and slowed 1 (1 round); Stage 2 3d6 poison damage, and slowed 1 (1 round); Stage 3 4d6 poison damage and paralyzed for 2d6 hours. Shuln saliva overcomes the inexorable ability.

Slumber Wine Item 12

Alchemical Consumable Ingested Poison Sleep

Price 325 gp; Usage held in 1 hand; Bulk L


Slumber wine sees its greatest use in games of intrigue, where an absence can be more devastating than injury. Characters unconscious from slumber wine can’t wake up by any means while the poison lasts, don’t need to eat or drink while unconscious in this way, and appear to be recently dead unless an examiner succeeds at a DC 40 Medicine check.


Saving Throw DC 32 FortitudeOnset 1 hour; Maximum Duration 7 days; Stage 1 unconscious (1 day); Stage 2 unconscious (2 days); Stage 3 unconscious (3 days).
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Spider Root Item 9

Alchemical Consumable Contact Poison

Price 110 gp; Usage held in 2 hands; Bulk L


A paste made by mashing the fine, threadlike roots of a certain creeper vine, spider root renders a victim clumsy and maladroit.


Saving Throw DC 28 FortitudeOnset 1 minute; Maximum Duration 6 minutes; Stage 1 8d6 poison damage and clumsy 1 (1 minute); Stage 2 9d6 poison damage and clumsy 2 (1 minute); Stage 3 10d6 poison damage and clumsy 3 (1 minute)
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Spider Venom Item 1

Maximum Duration 4 rounds. Stage 1 1d4 poison damage and enfeebled 1 (1 round); Stage 2 1d4 poison damage and enfeebled 2 (1 round).

  • Critical Success The target is unaffected.
  • Success The target takes 1d4 poison damage.
  • Failure The target is afflicted with spider venom at stage 1.
  • Critical Failure The target is afflicted with spider venom at stage 2.

Tears of Death Item 20

Alchemical Consumable Contact Poison Virulent

Price 12,000 gp; Usage held in 2 hands; Bulk L


Tears of death are among the most powerful of alchemical poisons, distilled from extracts of five other deadly poisons in just the right ratios.


Saving Throw DC 46 FortitudeOnset 1 minute; Maximum Duration 10 minutes; Stage 1 18d6 poison damage and paralyzed (1 round); Stage 2 25d6 poison damage and paralyzed (1 minute); Stage 3 30d6 poison damage and paralyzed (1 minute)
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Wolfsbane Item 10

Alchemical Consumable Ingested Poison

Price 155 gp; Usage held in 1 hand; Bulk L


Wolfsbane appears in folklore for its link to werecreatures. If you are afflicted with lycanthropy and survive Stage 3 of wolfsbane, you’re immediately cured of the lycanthropy.


Saving Throw DC 30 FortitudeOnset 10 minutes; Maximum Duration 6 minutes; Stage 1 12d6 poison damage (1 minute); Stage 2 16d6 poison damage (1 minute); Stage 3 20d6 poison damage (1 minute)
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Wyvern Poison Item 8

Alchemical Consumable Injury Poison

Price 80 gp; Usage held in 2 hands; Bulk L


Properly harvested and preserved, the poison from a wyvern’s sting is effective and direct.


Saving Throw DC 26 FortitudeMaximum Duration 6 rounds; Stage 1 5d6 poison damage (1 round); Stage 2 6d6 poison damage (1 round); Stage 3 8d6 poison damage (1 round)
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Section 15: Copyright Notice
Pathfinder Core Rulebook (Second Edition) © 2019, Paizo Inc.; Designers: Logan Bonner, Jason Bulmahn, Stephen Radney-MacFarland, and Mark Seifter.