of their flesh and their paltry souls too small

Maladies to contain such radiance.

The most common way to contract
adverse ascension is by use of the
Diseases commune spell, becoming afflicted once
every time the caster does not receive an
The rules for handling diseases are unique answer. A creature that takes radiant
to each disease. Whereas one affliction damage equal to triple its total Hit Dice from
might have an incubation period of several a celestial can also be afflicted.
weeks, others can prove lethal within Any creature overexposed to the divine
minutes. Some diseases infect only certain makes a DC 15 Wisdom saving throw or
types of creatures or affect their hosts in becomes infected with adverse ascension.
different ways. While victims of disease can In the first phase of adverse ascension the
sometimes recover naturally, supernatural infected creature’s dreams and daydreams
diseases often require magic to cure (such start featuring more of the deity’s aspects
as a lesser restoration spell). Particularly and iconography.
virulent diseases might resist even magical After 1d4 days of the disease’s first stage
healing. Only rare medicines or the the infected creature must succeed on a DC
intervention of the gods can halt such 12 Charisma saving throw or proceeds to
plagues. the second stage of infection, gaining a
short-term mental stress effect whenever it
Treating Diseases commits an act of devotion to any other god
than the one worshiped by the celestial that
Treating a diseased creature over the afflicted it. On a success, the creature
course of a short rest with a successful recovers from the disease.
Medicine check (tier 1: DC 10, tier 2: DC 14, At the end of each long rest, an infected
tier 3: DC 18, tier 4: DC 22) grants creature makes a Charisma saving throw
advantage on its next saving throw against against a DC determined by infection stage
the disease. (first stage DC 12, second stage DC 13,
third stage DC 14). The saving throw is
Sample Diseases made with disadvantage if within the last 24
hours the infected creature witnessed divine
Each of the following example diseases spellcasting by any follower of the same
includes a general range of adventurers it is deity as the one it is being drawn to.
intended to be used against: tier 1 (1st–4th On a success while suffering from the
level), tier 2 (5th–10th level), tier 3 second or third stage of infection, the
(11th–16th level), or tier 4 (17th–20th level). infected creature regresses to the previous
Narrators that want to introduce a disease stage of infection.
above or below the party’s current tier can On a failure while suffering from the
adjust the specifics of the disease to match second stage of infection, the infected
their resilience and capabilities. Such creature gains an ideal: “All must know how
adjustments might include raising or great my deity is.” This can manifest in
lowering the saving throw DCs of the many ways, such as muttered whispered
disease, changing the disease’s symptoms, scriptures, or as proudly trying to convert
or making the disease easier (or more everyone around, depending on the person.
difficult) to cure. The infected creature begins to show a
miraculous understanding of the Outer
Planes that gives it advantage on Religion
Adverse Ascension (Tier 2) checks. An infected creature that fails a
Being exposed to too much unfiltered godly second saving throw progresses to the third
glory is deadly to mortals, the simple matter stage of adverse ascension.

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 On a failure while suffering from the third purge all traces of the triggering spell from
stage of infection, the infected creature can its mind. To do so, the creature must spend
cast shield of faith once between rests. For 24 hours without casting spells or cantrips,
the spell’s duration, the infected creature using class features or other abilities
begins to gently fade into the Astral Plane involving magic, or activating magic items. If
as it is drawn to the divine. At the start of these conditions are met, the next time the
each of its turns, the infected creature creature saves against the disease, it
makes death saving throws as if dying. The recovers on a success. A recovered
infected creature still acts on its turn as creature can reduce levels of strife as
normal, but after three failures it normal. On a failed save, the creature’s
dematerializes into the heavens never to be condition worsens, although it can attempt
seen again. Other creatures can use the to recover again by repeating the purging
Help action to grant the infected creature process.
advantage on these saves by speaking
encouraging words to it.
After a priest of the same or a similar faith
Cackle Fever (Tier 3)
has spent 7 days in one-on-one theology Also known as ‘the shrieks’, cackle fever
seminars with the infected creature, it can afflict any humanoids except gnomes,
makes a DC 12 Charisma saving throw, who are mysteriously immune to the
curing the disease on a success. affliction. The disease’s symptoms include
fever, disorientation, and fits of laughter that
are literally contagious.
Arcane Autophagy (Tier 4) A creature infected with cackle fever
Arcane autophagy occurs when the energy suffers 1 level of fatigue 1d4 hours after
of a powerful spell devours the contracting the disease. Until the disease is
consciousness of the creature casting it. cured, the creature cannot recover from this
Despite this disease’s name, mages, the level of fatigue. Whenever the creature
servants of the gods, and champions of experiences stress (including entering
nature are all vulnerable to arcane combat or taking damage), it makes a DC
autophagy. 13 Constitution saving throw. On a failed
Whenever a creature casts a 9th-level save, it takes 5 (1d10) psychic damage and
spell, roll 1d20. On a result greater than the is incapacitated as it cackles maniacally for
creature’s spellcasting level, it may become 1 minute. At the end of each of its turns, a
afflicted with arcane autophagy. The cackling creature can repeat the saving
creature makes a DC 20 saving throw using throw to stop laughing and end the
its spellcasting ability. On a failed save, the incapacitated condition.
creature becomes infected with arcane When a creature starts its turn within 10
autophagy and suffers 1 level of strife, or 2 feet of a cackling creature, it makes a DC
levels on a failure by 5 or more. 10 Constitution saving throw. On a failed
Once infected, the creature repeats the save, it also becomes infected with cackle
saving throw each time it finishes a long fever, or on a success it becomes immune
rest. The creature must also repeat the save to infection from that creature’s cackle fever
whenever it casts the spell that triggered the for 24 hours.
disease. On a failed save, the creature A creature infected by cackle fever makes
suffers another level of strife, or 2 levels on a DC 13 Constitution saving throw
a failure of 5 or more. whenever it finishes a long rest. On a
Lesser restoration has no effect on arcane success, the DC of this saving throw and
autophagy. A greater restoration spell the saving throw to avoid a cackling fit are
removes 1 level of strife from the afflicted reduced by 1d6. The creature recovers from
creature but does not end the disease. To the disease when the DC drops to 0. If the
fully recover, the infected creature must creature fails three such saving throws

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before the disease ends, it gains a cures demon fever. When afflicted by a
long-term mental stress effect. night hag, the creature can choose to end
Gnolls are particularly susceptible to the infection at any time.
cackle fever and have disadvantage on
saving throws made against the disease.
However, a gnoll is not incapacitated while
Fey Longings (Tier 2)
in the grips of a cackling fit and instead The Dreaming is a wondrous realm, so
gains advantage on attack rolls. enchanting that some start to long for it
without ever having been there. After any
personal, intimate interaction with a fey, a
Delver’s Lung (Tier 1) creature must succeed on a DC 10 Wisdom
Delver’s lung is caused by inhaling the mold saving throw or be infected. Fey aware of
spores that often infest dungeons and other this danger can take special precautions to
subterranean spaces. Though pernicious, prevent it using wards made from special
delver’s lung is rarely fatal. plants and oils and though most know this,
A beast or humanoid exposed to delver’s few care. Creatures with fey ancestry (such
lung must succeed on a DC 12 Constitution as elves, gnomes, and half-elves) are
saving throw or become infected. Whenever immune.
an infected creature takes the Dash or It takes 1d4 days for the symptoms of fey
Sprint action, it repeats the saving throw, longings to take hold. The infected creature
suffering 1 level of fatigue on a failure. sees fey wherever they look. At first it’s the
Each time an infected creature finishes a giggling sound of pixies just behind the next
long rest, it repeats the saving throw, with tree, but after several days it’s not
advantage if the rest was completed in an uncommon for the delusions to include
environment with clean, fresh air. After being surrounded by thick vines, glistening
succeeding on three consecutive saving psychedelic rains, or riding a
throws, the disease ends. A creature that colorfully-feathered frog (while in fact the
finishes a long rest on the Elemental Plane infected creature might be tangled in ropes,
of Air automatically recovers from the showered in blood, or standing on a
disease. swift-moving boat). While these vivid
hallucinations are complete, they do not
directly lead to a creature being harmed or
Demon Fever (Tier 2) put into harm’s way.
Ghouls native to the infernal realms carry an When the infected creature makes an
illness known as demon fever in their bile. opposed Deception, Insight, Intimidation, or
Night hags (who are immune to this Persuasion check, it makes a DC 12
disease) sometimes smear ghoul bile on Wisdom saving throw. On a failure, the
their lips to infect their mortal lovers. infected creature is charmed by one random
A humanoid exposed to demon fever must creature it can see. This creature cannot be
succeed on a DC 14 Constitution saving an ally of the infected creature. If there’s no
throw or be infected. Terrifying dreams viable target, the infected creature instead
plague an infected creature’s sleep. has disadvantage on attack rolls and ability
Whenever the creature attempts to take a checks as it sees and tries to interact with a
long rest, it must succeed on a DC 14 world beyond the veil.
Wisdom saving throw or it gains no benefit The best cure for fey longings is to bring
from the rest. the infected creature to the Dreaming to
A protection from evil and good or magic interact with its denizens and environment.
circle spell cast on an infected creature At the end of each day spent in the
prevents the nightmares for 24 hours, Dreaming, an infected creature makes a DC
allowing it to benefit from a long rest. A heal 10 Wisdom saving throw to recover from the
spell or more powerful magic permanently

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disease. Otherwise fey longing naturally the end of which the infected creature
fades after 1 month. recovers.
There are legends about living with
fractured rift disorder as well, the most
Fractured Rift Disorder (Tier popular claiming that an old dwarven hero
2) infected with it crafted a pair of magical iron
Frequent travel beyond the Inner and Outer boots to keep himself grounded.
Planes dilutes a soul’s tether to its original
plane of existence. Spells such as plane TABLE: FRACTURED RIFT DISORDER
shift and well-made portals are generally FRACTURE WORSENS
safe, allowing for a smooth transition LEVEL CUMULATIVE EFFECT WHEN...
between dimensions, but journeying by Succeed on a DC 12 Failing a DC 15
other means can have ill effects. Whenever Constitution save after Constitution
a creature travels between planes using a taking a level of fatigue or saving throw at
Basic
strife, or teleport 1d20 feet the end of a
naturally occurring portal or dangerous in a random direction. week of
magical item (like a well of many worlds), it adventuring.
must succeed on a DC 15 Constitution Make a DC 12 Constitution Failing a DC 17
saving throw or be infected with fractured rift save after scoring or Constitution
disorder. taking a critical hit, saving throw at
Mild
Whenever the infected creature suffers a teleporting 1d20 feet in a the end of a
level of fatigue or strife, its connection to the random direction on a week of
failure. adventuring.
Material Plane is tested and it makes a DC
12 Constitution saving throw. On a failure, Become ethereal (as the Automatically
blink spell) whenever the worsens after
the infected creature is teleported 1d20 feet
infected creature rolls a several weeks
away in a random horizontal direction as its natural 1 on a d20. Make a not spent
connection to the here and now shifts Severe
DC 12 Dexterity saving resting.
slightly. throw to avoid dropping
Unless treated (see below) the rift held items just before the
transition.
continues to fracture and the infection
worsens. At the end of every week during When the infected —
which a creature with a basic or mild creature has been
targeted by a magical
infection does more than rest, it makes a effect that changes its form
DC 15 Constitution saving throw. On a or location within the last
failure, the disease worsens as per Table: round and it makes a
Fractured Rift Disorder. On a success, its Deadly Strength check, melee
attack roll, or attacks with
infection is reduced by one stage (from mild a thrown weapon, it makes
to basic, or basic to recovered). a DC 10 Constitution
All of this disease’s effects manifest only saving throw or it is
while on the Material Plane. transported to a random
Restoration and similar magic have no plane of existence.
effect on fractured rift disorder since the
problem can’t be fixed with positive energy.
Instead the infected creature needs to
strengthen its connection to the world. A
druid or similarly nature-oriented person can
diagnose the disease with a DC 18 Nature
check and prescribe a long-term treatment,
usually requiring a month of peaceful
meditation in an ancient grove or cave at

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Netherblight (Tier 3) Pastrasite (Tier 3)
Whenever a dead humanoid is restored to This chrono-active parasite is native to
life (via a raise dead spell, for example), roll Limbo, a result of the ever-shifting
1d20. On a result greater than the environment in which even time is
creature’s level (or challenge rating), it may malleable. Unfortunately pastrasites are
become afflicted with netherblight. The drawn to the Material Plane where the rigid
creature must succeed on a DC 17 temporal structure of past, present, and
Charisma saving throw or be infected. future provides an excellent foundation to
Whenever a creature infected with cling to. They are usually contracted in
netherblight finishes a long rest, it makes a places of historical significance where they
DC 17 Charisma saving throw. On a failure, exist in a dormant state around the time of
it gains a randomly determined malady as the event itself, looking into the future in
per Table: Netherblight. If this would result search of visitors who have an especially
in an effect the creature already suffers interesting past—adventurers.
from, the victim’s malady does not worsen There’s no certainty as to what a
but it has disadvantage on its next saving pastrasite looks like as they can only be
throw against the disease. detected by their symptoms. They never
Only powerful magic (such as a wish come in contact with the infected creature
spell), a divine miracle, or the completion of itself, instead consuming the creature’s
a quest determined by the Narrator can cure background, subsiding on the temporal
a creature afflicted with netherblight. backlash that results when the timeline
snaps back.
TABLE: NETHERBLIGHT When an adventurer enters an area with
1D6 MALADY
pastrasites they make a DC 15 Charisma
saving throw as their psyche instinctively
The creature’s voice becomes flat and tries to maintain their personal timeline.
lifeless, and it has disadvantage on On a success, the pastrasite immediately
1
Deception and Persuasion checks made to retreats, choosing another adventurer to
influence living creatures.
infect until there are none. For the next
The creature’s zest for life fades, and it several hours the adventurers have
2 becomes unable to gain inspiration or benefit advantage on Intelligence checks made to
from Bardic Inspiration. recall information.
The creature’s type changes to undead. At On a failure, the adventurer becomes
the Narrator’s discretion, mindless undead infected and the pastrasite immediately
3
(such as skeletons or zombies) may ignore destroys several years of their past. The
the creature’s presence. infected adventurer loses its background
The gods themselves shun the creature. and gains a randomly determined
Whenever a spell or magical effect would background. This new background is
4 restore the creature’s hit points, the creature now—and always has been—the
regains only half the hit points it would have adventurer’s past. The adventurer is
normally regained. vaguely aware of what happened with
The creature’s grip on life becomes tenuous blurred recollection of things being
5 and it has disadvantage on death saving somehow different than before becoming
throws. infected. Only spells that contact other
planes can reveal information from the
Death calls for the creature’s return. The
creature gains the doomed condition, dying infected adventurer’s previous timeline.
at a time determined by the Narrator. A spell Most facts change as little as possible to
6 remain consistent with the infected
of 7th-level or higher (such as resurrection)
can remove the doomed condition but does adventurer’s new past, but some friction
not cure the disease. remains. Whenever an inconsistency

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between the old and new timelines is first A beast or humanoid exposed to scree
spoken of in front of the infected adventurer, scale must succeed on a DC 15
it takes 10 (3d6) psychic damage. Constitution saving throw or be infected.
The new timeline gradually settles, and the After 1d10 days, an infected creature’s skin
true past can only be restored through develops pebble-like growths that spread for
powerful magic such as wish. Once a as long as the disease persists. Every 1d10
pastrasite has altered an adventurer’s days, the infected creature repeats the
timeline, although its effects remain the saving throw, curing itself of the disease
adventurer recovers from the disease. after three successful saves. A lesser
Spells like remove disease or features like a restoration spell also cures the disease.
herald’s Lay on Hands have no effect on An infected creature that fails the saving
pastrasites. throw three times before the disease ends
becomes a creature of living stone. In this
form, the creature’s type changes to
Rotter Plague (Tier 1) elemental, and it gains resistance to
Some zombies are creations of magic but bludgeoning, piercing, and slashing damage
others are the spawn of an affliction known from nonmagical weapons that aren’t
as rotter plague. adamantine. Once scree scale has
Zombies infected with rotter plague hunger progressed to this stage, only greater
for living flesh. A rotter zombie has a speed restoration or more powerful magic can
of 35 feet, advantage on initiative checks, reverse the effect.
and gain the following attack: A creature of living stone repeats the
Bite. Melee Weapon Attack: +3 to hit, saving throw every 1d10 days. On a failure,
reach 5 ft., one target. Hit: 3 (1d4+1) the creature becomes petrified until the
piercing damage. If the target is a living disease is cured. If the infected creature
creature, it must succeed on a makes three successful saving throws
Constitution saving throw (DC 10 + the before becoming petrified, the disease’s
damage dealt) or be infected with rotter progression halts and it remains in its living
plague. stone form until cured.
A living creature infected with rotter plague
suffers no negative effects from the disease Sewer Plague (Tier 1)
and cannot transmit it unless it dies. An
infected creature that dies rises as a rotter Unsanitary conditions give rise to all manner
zombie after 1 minute. Sprinkling the of pestilence generically referred to as
creature’s corpse with holy water or dealing sewer plague. Contact with rotting waste or
it at least 1 damage prevents this stagnant water can transmit sewer plague,
transformation. A gentle repose spell cast as can the bites of rats and other creatures
on the body also prevents it from rising as a that live amid such filth.
rotter zombie for the spell’s duration. A humanoid exposed to sewer plague
Lesser restoration cures rotter plague. must succeed on a DC 11 Constitution
Casting lesser restoration on an infected saving throw or be infected. After 1d4 days,
zombie removes its ability to transmit rotter an infected creature experiences cramps
plague but has no other effect. and exhaustion. The creature suffers 1 level
of fatigue, it recovers only half the normal
amount of hit points when spending Hit
Scree Scale (Tier 2) Dice, and it regains no hit points upon
Prolonged exposure to the Elemental Plane completing a long rest.
of Earth sometimes results in the An infected creature repeats the saving
extraplanar malady known as scree scale. throw whenever it finishes a long rest. On a
Though slow acting, an untreated case of failure, it suffers an additional level of
scree scale can be debilitating. fatigue. On a success, the creature instead

A5E System Reference Document

recovers from 1 level of fatigue. The In 1d4 days the spectral thought-worm’s
creature is cured of this disease when it has symptoms manifest in an infected creature.
no levels of fatigue. The parasite infestation spreads and they
eat the infected creature’s psyche, creating
a mental space into which they lay eggs. An
Sight Rot (Tier 1) infected creature has its memories altered
A beast or humanoid that drinks water (as the modify memory spell with no save),
tainted with sight rot must succeed on a DC completely forgetting the events within 1d4
15 Constitution saving throw or be infected. hours before and 1d4 hours after its
After 24 hours, an infected creature’s vision affliction.
begins to blur, imposing a –1 penalty to When an infected creature finishes a long
attack rolls and sight-based ability checks. rest, it repeats the saving throw.
Each time the creature finishes a long rest, On a success, the infected creature’s mind
the penalty worsens by 1. Once the penalty fights against the spectral thought-worms
reaches –5, the creature is blind for as long and in the resulting struggle its memory is
as it remains diseased. altered, forgetting the events within the last
A lesser restoration spell or similar magic 2d4 hours.
cures sight rot, as does the application of an On a failure, the worm clears enough
ointment extracted from eyebright (a rare space to lay eggs that hatch in 1d4 days.
flower found in some swamps). An hour of These start eating the infected creature’s
work with a single eyebright flower and a personality, reducing its Charisma by 1 at
DC 14 herbalism kit check produces one the end of each long rest. When an infected
dose of the ointment. Applying the ointment creature’s Charisma score is reduced to 0
to an infected creature’s eyes during a long and it dies, the spectral thought-worms
rest prevents the disease from worsening, escape to the Astral Plane through the tiny
and three applications of the ointment cures planar opening created by the departing
sight rot. soul.
Spectral thought-worms are susceptible to
Spectral Thought-Worms (Tier psychic damage (thus their penchant to hide
within minds as a shield against astral
4) energies). When an infected creature is
Spectral thought-worms are tiny parasitic targeted by lesser restoration, or takes
creatures native to the Astral Plane. Their psychic damage equal to or more than its
preferred habitat is a conscious mind where Charisma score, the parasite goes dormant
they subside on thoughts and ideals. When for 1 week. A dormant spectral
a creature interacts with the Astral Plane thought-worm is destroyed when the
(via the astral projection spell or magic item infected creature takes psychic damage
mishaps) without the protection of a mind equal to or more than its Charisma score.
blank spell, or when it suffers prolonged Upon destruction a spectral thought-worm
exposure to the less stable areas of the dissolves into stray thoughts that are
Astral Plane’s wild energies, roll 1d20. On a expelled throughout the next day as
result equal to or less than its level (or CR), semi-insightful sayings that float through the
it may become afflicted with this disease. creature’s mind.
Spectral thought-worms can also be carried
along a detect thoughts spell, telepathic Troll Pox (Tier 2)
connections, and similar effects. A creature
exposed to a spectral thought-worm or an This virulent disease originated in trolls but
infected creature’s mind must succeed on a has since spread to other creatures. Troll
DC 16 Charisma saving throw or be pox manifests as an outbreak of boils that
infected. are rapidly replaced by tumorous growths.

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 Whenever a creature infected with troll pox the poison as an improvised weapon. On
takes bludgeoning, piercing, or slashing a hit, the target is subjected to the poison.
damage, each living creature within 5 feet of The poison retains its potency for 1
it must succeed on a DC 17 Constitution minute or until you hit with the weapon or
saving throw or be infected. After 1d4 hours, ammunition.
an infected creature’s skin erupts with boils. Ingested. Ingested poisons are only
Though unpleasant, the initial stage of troll dangerous when consumed. The dose
pox is harmless to the victim. However, can be delivered in food or a liquid. When
each time the creature finishes a long rest, it a creature consumes a full dose of
repeats the saving throw. On a failure, the ingested poison it is subjected to the
boils burst to reveal a host of fast-growing poison. If a dose is only partially
tumors. The creature’s hit point maximum is consumed the creature is subjected to the
reduced by 5 (1d10). Each time the creature poison, but it has advantage on saving
fails the Constitution saving throw, its hit throws made against the poison and only
point maximum is reduced by an additional takes half of any damage the poison
5 (1d10) points. The target dies if this effect inflicts.
reduces its hit point maximum to 0. Inhaled. These poisons are powders or
In addition, the creature gains the following gases that take effect when inhaled. You
trait: can use an action to blow these poisons
Regeneration. The creature regains 10 onto a target within 5 feet of you, or throw
hit points at the start of its turn. If the them up to 20 feet where they shatter and
creature takes acid or fire damage, this form into a 5-foot radius cloud on impact.
trait doesn’t function at the start of its next In either case, make a ranged weapon
turn. The creature dies only if it starts its attack against the target, treating the
turn with 0 hit points and doesn’t poison as an improvised weapon. On a
regenerate. hit, the target is subjected to the poison.
Infected creatures can live with troll pox for Clouds of poisons formed in this way
extended periods, but they never recover remain for 1d4 rounds or until harmlessly
naturally. Only a greater restoration spell or dispersed by a moderate or stronger
similar magic can cure the disease. wind. When a creature enters a poison
cloud’s area for the first time on a turn or
ends its turn there it is also subjected to
Poisons the poison. Creatures that do not breathe
are immune to these poisons.
Injury. Injury poison can be applied to
Poison Vectors weapons, ammunition, trap components,
Poisonings must be delivered using one of and other objects that deal piercing or
four different vectors to be effective slashing damage. As an action you can
(determined by the type of poison). coat one slashing or piercing weapon, or
Contact. Contact poison can be up to 3 pieces of ammunition. The poison
smeared on an object, weapon, or up to 3 retains its potency for 1 minute or until
pieces of ammunition as an action, and you hit with the weapon or ammunition. A
remain potent until it is touched or creature that takes piercing or slashing
washed off. A creature that touches damage from an object coated with the
contact poison with exposed skin is poison is subjected to the poison.
subjected to the poison. You can also use A creature that is immune to the poisoned
an action to splash these poisons onto a condition is also immune to the effects of
target within 5 feet of you, or throw them any poisons it is subjected to.
up to 20 feet where they shatter on
impact. In either case, make a ranged
weapon attack against the target, treating
A5E System Reference Document
Poison Onsets While the simple mineral has many
innocuous uses, it still numbers among the
Many poisons work instantaneously but it most prolifically used deadly poisons. A
can often take minutes, hours, or even days creature makes a DC 16 Constitution saving
for foul ichors to complete their destructive throw when subjected to this poison. On a
work. failed saving throw, it takes 14 (4d6) poison
Instantaneous. When a creature is damage and is poisoned and incapacitated
subjected to an instantaneous poison for 24 hours. On a successful saving throw,
they are subjected to the poison’s effects the creature takes half damage and isn’t
and immediately make saving throws poisoned or incapacitated.
against it.
Onset Duration. Creatures subjected to
a poison with an onset duration are Basilisk Drool
subjected to the poison’s effects and Uncommon, contact, instantaneous, cost
make saving throws against it at the end 125 gold
of the onset duration. A basilisk’s mouth is among the world’s
most putrid locations. A creature makes a
Poison Cost and Rarity DC 12 Constitution saving throw when
subjected to this poison, taking 7 (2d6)
Much like magic items, each poison has a poison damage on a failure, or half as much
rarity (common, uncommon, rare, very rare, damage on a success.
or legendary) and a cost in gold for a single
dose. These costs and ratings are optional
guidelines for the Narrator to follow for Belladonna
optimal gameplay, but can be adjusted to Uncommon, ingested, onset (10 minutes),
better suit a given campaign—what follows cost 450 gold
assumes that most particularly potent Commonly known as deadly nightshade. A
poisons are either hard to come by or their creature makes a DC 14 Constitution saving
creation is outlawed. throw when subjected to this poison, and on
a failure it becomes poisoned for 8 hours
Treating Poisons and takes 14 (4d6) poison damage. On a
failure by 5 or more, the creature is also
Spending 1 minute treating a poisoned
unconscious while poisoned in this way. The
creature with a successful Medicine check
creature wakes up if it takes damage or if
(DC equal to the poison’s saving throw DC)
another creature uses an action to shake it
ends the poisoned condition, though the
awake.
creature is not cured of any damage it has
If a creature with lycanthropy consumes
taken from the poison.
this poison before their first transformation,
they may make another saving throw
Sample Poisons against the effect that afflicted them, ending
the lycanthropy permanently on a success
Many of the poisons found here are the (in addition to the poison’s other effects).
natural toxins of creatures and can be
harvested directly from them using a
poisoner’s kit. Burnt Othur Fumes
Uncommon, inhaled, instantaneous, cost
Arsenic 450 gold
Othur bog mold emits caustic spores that
Uncommon, ingested, onset (30 minutes), are both toxic and intensely flammable. A
cost 300 gold creature makes a DC 13 Constitution saving
throw when subjected to this poison, taking
A5E System Reference Document
10 (3d6) poison damage on a failure, or half on a failure, or half as much damage on a
as much on a success. Additionally, a success.
creature that fails its saving throw takes an
additional 3 (1d6) ongoing poison damage
for the next 3 rounds.
Naga Spit
If a cloud of this poison is exposed to an Rare, contact, instantaneous, cost 1,000
open flame or any target within it takes fire gold
damage, the 5-foot radius cloud is A creature makes a DC 15 Constitution
immediately dispersed as it explodes. Each saving throw when subjected to this poison,
creature in the area makes a DC 13 taking 45 (10d8) poison damage on a
Dexterity saving throw, taking 10 (3d6) fire failure, or half as much damage on a
damage on a failure, or half as much on a success.
success.
Oil of Taggit
Chuul Ichor Uncommon, contact, instantaneous, cost
Uncommon, injury, instantaneous, cost 350 400 gold
gold The roots of the taggit plant can be
This slime can be carefully harvested from concentrated into this slick, gray, odorless
a chuul’s tentacles. A creature makes a DC oil. A creature makes a DC 13 Constitution
13 Constitution saving throw when saving throw when subjected to this poison,
subjected to this poison, and on a failure it and on a failure it becomes poisoned for 24
becomes poisoned for 1 minute. Creatures hours. Creatures poisoned in this way are
poisoned in this way are also paralyzed. also knocked unconscious. The creature
The poisoned creature repeats its saving wakes up if it takes damage.
throw at the end of each of its turns, ending
the poison’s effects on a success.
Pale Tincture
Couatl Venom Rare, ingested, onset (24 hours), cost 650
gold
Rare, injury, instantaneous, cost 850 gold This malicious alchemical agent slowly
Couatl sometimes gift their iridescent eats away at the internal organs of its
venom to those that have won their favor. A victim. A creature makes a DC 16
creature makes a DC 13 Constitution saving Constitution saving throw when subjected to
throw when subjected to this poison, and on this poison, and on a failure it takes 3 (1d6)
a failure it becomes poisoned for the next poison damage, its maximum hit points are
24 hours. Creatures poisoned in this way reduced by the same amount, and it
are also knocked unconscious. The creature becomes poisoned. The effects of this
wakes up if it takes damage or if another poison repeat every 24 hours until cured or
creature uses an action to shake it awake. until 1 week passes (whichever comes first).
This poison and all of its effects can be
cured by the greater restoration spell. Any
Green Dragon Breath hit point reduction caused by this poison
Rare, inhaled, instantaneous, cost 1,650 lasts until the poison is cured or 1 week
gold passes.
Although it is not as potent in this powder
form, the distilled draconic bile is still quite
noxious. A creature makes a DC 18
Perdita’s Abandon
Constitution saving throw when subjected to Rare, ingested, onset (1 minute), cost 1,750
this poison, taking 28 (8d6) poison damage gold

A5E System Reference Document

 A creature makes a DC 16 Wisdom saving The venom sacs of exotic serpents can be
throw when subjected to this poison, and on carefully extracted and repurposed. A
a failure it becomes rattled for the next 24 creature makes a DC 11 Constitution saving
hours. This poison and all of its effects can throw when it is subjected to this poison,
be cured by the greater restoration spell. taking 11 (3d6) poison damage on a failure,
or half as much damage on a success.
Powdered Fiendhorn
Rare, inhaled, instantaneous, cost 3,500
Shadow Poison
gold Uncommon, injury, instantaneous, cost 200
A creature makes a DC 15 Constitution gold
saving throw when subjected to this poison. This bright purple sleeping agent is
On a failed saving throw, a creature takes typically brewed by shadow elves. A
11 (3d6) necrotic damage and 11 (3d6) creature makes a DC 13 Constitution saving
poison damage, and it becomes poisoned throw when it is subjected to this poison,
for 1 minute. While poisoned in this way the and on a failure it becomes poisoned for 1
creature becomes vulnerable to necrotic hour. On a failure by 5 or more, the creature
damage. A creature that succeeds on its is also unconscious while poisoned in this
saving throw takes no damage from this way. The creature wakes up if it takes
poison. damage or if another creature takes an
action to shake it awake.
Pseudodragon Poison
Common, injury, instantaneous, cost 50
Striped Toadstool
gold Common, ingested, onset (1 hour), cost 50
Though it is rarely given willingly, this gold
kaleidoscopic liquid is drawn from the These red-striped mushrooms are well
diminutive stinging tail of the humble known as toxic to forest foragers. A creature
pseudodragon. A creature makes a DC 11 makes a DC 12 Constitution saving throw
Constitution saving throw when subjected to when it is subjected to this poison, and on a
this poison, and on a failure it becomes failure it becomes poisoned for 1d4 + 2
poisoned for 1 hour. On a failure by 5 or hours. Creatures poisoned in this way also
more, the creature falls unconscious for the have disadvantage on Wisdom checks and
same duration, or until it takes damage or saving throws. Prior to the onset, this poison
another creature uses an action to shake it can be counteracted by the lesser
awake. restoration spell or any ability that would
cure the poisoned condition.
Purple Worm Poison
Rare, injury, instantaneous, cost 2,000 gold
Truth Serum
This dark magenta toxin is harvested from Uncommon, ingested, instantaneous, cost
the fearsome purple worm. A creature 450 gold
makes a DC 19 Constitution saving throw This clear alchemical concoction unlocks
when subjected to this poison, taking 42 and untethers the mind. A creature makes a
(12d6) poison damage on a failure, or half DC 14 Constitution saving throw when it is
as much damage on a success. subjected to this poison, and on a failure it
becomes poisoned for 1 hour. While
poisoned in this way a creature cannot
Serpent Venom knowingly lie, as per the zone of truth spell,
Common, injury, instantaneous, cost 75 using the poison’s DC as the spell save DC.
gold
A5E System Reference Document
Walking Death
Legendary, ingested, onset (3 days), cost
60,000 gold
The shredded petals of this black
flower—said to only grow in the land of the
dead—are the most potent known poison. A
creature makes a DC 28 Constitution saving
throw when it is subjected to this poison,
and on a failure it is doomed. Prior to the
onset, this poison can only be counteracted
by the wish spell or similar magic.

Wyvern Poison
Rare, injury, instantaneous, cost 1,200 gold
It is practically impossible to take from a
living specimen, but once slain the toxin
drawn from a wyvern’s stinging tail is lethal.
A creature makes a DC 15 Constitution
saving throw when it is subjected to this
poison, taking 24 (7d6) poison damage on a
failure, or half as much damage on a
success.

A5E System Reference Document