Malpractice never looked this fun. A falling-pill puzzle roguelike where you cure patients, climb a 10-floor hospital, and build runs from 32 prescriptions, five flawed doctors, and no clean bill of health.

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About This Game

Match falling pills to clear rows of viruses, then keep climbing. Adverse Reaction sends you up a 10-floor hospital, one patient at a time, in a roguelike built on real-time puzzle skill: line up colors, chain clears for cascading combos, and watch the danger meter (and your patient-monitor HUD) tell you exactly how close the next mistake is to a flatline.

Between patients, prescriptions reshape your bottle on the fly, setting off chain reactions, painting rows into a single rainbow color, or spreading outbreak damage virus-to-virus, and every doctor except the Intern comes with a built-in adverse reaction, so you're always weighing a perk against its cost.

As you improve, crank up Malpractice difficulty for faster pills, tougher bosses, more aggressive viruses, and a start-of-run reaction you didn't choose, all layered onto the same 10 floors. Or take on the same seeded map everyone else is playing that day in Daily Run, and see where you land on the leaderboard.

Key Features

  • Real-time falling-pill puzzle combat across a 10-floor hospital

  • 32 prescriptions spanning four build archetypes: chain reactions, color-matching, demolition, and outbreak spread

  • Five playable doctors, each carrying a built-in adverse reaction as the cost of their perk

  • Stacking Malpractice difficulty (levels 1-8) for repeatable, escalating challenge runs

  • Daily Run mode on a shared seeded map with its own leaderboard

  • Pharmacy, Recovery, and Clinical Trial rooms for build-shaping risk/reward choices between fights

AI Generated Content Disclosure

The developers describe how their game uses AI Generated Content like this:

Copy for the store page and localization in game and on the store page was generated by AI

System Requirements

Windows
macOS
SteamOS + Linux
    Minimum:
    • OS: Windows 10 64-bit
    • Processor: Dual-core 2.0 GHz (Intel Core i3 / AMD Athlon or equivalent)
    • Memory: 2 GB RAM
    • Graphics: Integrated graphics, OpenGL 3.3 / GLES3 support (Intel HD 4000 or equivalent)
    • DirectX: Version 10
    • Storage: 300 MB available space
    • Sound Card: DirectX compatible
    Minimum:
    • OS: macOS 11 Big Sur or later
    • Processor: Apple Silicon (M1) or Intel Core i5
    • Memory: 4 GB RAM
    • Graphics: Integrated graphics (Apple GPU or Intel Iris)
    • Storage: 300 MB available space
* Starting February 15, 2024, the Steam Client will no longer support 32-bit games or macOS 10.14 or lower.
    Minimum:
    • OS: Ubuntu 20.04 or newer (64-bit)
    • Processor: Dual-core 2.0 GHz (Intel Core i3 / AMD Athlon or equivalent)
    • Memory: 2 GB RAM
    • Graphics: Integrated graphics, OpenGL 3.3 support (Intel HD 4000 or equivalent), X11 or Wayland
    • Storage: 300 MB available space
    • Sound Card: OpenAL/ALSA compatible
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