NSW Health has warned the public of a high-dose MDMA pill circulating in the community, which has twice the average amount of the drug in it.
The purple and grey-coloured pill has a Punisher skull on the front and is shaped like a pentagon.
The type of pill was found to contain double the average dose of MDMA.
Medical Director of the NSW Poisons Information Centre Darren Roberts said consuming a large quantity of MDMA could cause serious illness or death.
"The amount of MDMA in a tablet or capsule can vary a lot, even within the same batch. The health risks from MDMA are greatly increased if high amounts (including multiple doses) are consumed over a short period," Roberts said.
"Other risks include taking MDMA in combination with other stimulants, such as amphetamines or cocaine.
"Hot environments, such as at music festivals, increase the risk of harm from MDMA.
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"Taking a break from dancing, seeking shade, and drinking water are important measures to reduce the risk of overheating.
"It is very important to remember, if you or a friend has taken drugs and feel unwell, you won't get into trouble for seeking medical care.
"If you or a friend feels unwell, please seek help immediately by calling Triple Zero."
MDMA can cause severe agitation, raised body temperature, seizures or fits, irregular heart rhythm and death, Roberts also said.