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High and variable dose MDMA (ecstasy) tablets – orange spade-shaped, often with an ‘Ace of Spades’ logo

Source: NSW Health
Drug sold as: MDMA

Reason for concern: High or variable potency

Warning: high dose MDMA tablets have been found in NSW. The MDMA dose in these tablets averaged 146 mg, but some tablets contained up to 168 mg. This is double the amount usually contained in MDMA tablets circulating in NSW.

Please note: images are representative only and tablets may vary in colour or logo

Photos of a spade-shaped pill with an 'A' carved into the front. The back of the pill is flat.

Know the risks

  • You are at increased risk of harm if you:
    • take multiple MDMA (ecstasy) tablets or capsules
    • take a higher-dose MDMA (ecstasy) tablet or capsule
    • use other stimulant drugs (e.g. methamphetamine, cocaine or caffeine) at the same time
    • take MDMA in a hot environment like a music festival or indoor dance party
  • MDMA (ecstasy) is often poorly manufactured and the amount of MDMA in a tablet or capsule can vary a lot, even within the same batch.
  • The time from taking the drug to feeling any effect can vary significantly depending on the drug as well as the individual person.
  • High dose MDMA (ecstasy) use has been linked to death and other serious harms, including recent ICU admissions.

Effects to look out for

Feeling really hot and sweaty, light headedness, rigid muscles (e.g. difficulty walking), confusion or agitation, racing pulse/heart, feeling aggressive, uncontrolled repetitive movements, vomiting, seizures, difficult to rouse / unconscious.

If you experience these symptoms after taking MDMA, get help immediately.

Getting help

If you or your friends see the warning signs of overdose:

  • Seek help immediately from your nearest emergency department or call Triple Zero (000). You won’t get into trouble for seeking medical care.
  • Start CPR if someone is not breathing.

Support and advice

For free and confidential advice:

Reproduced by permission, NSW Health © 2023.