The global prevalence of counterfeit and low-quality pharmaceuticals poses significant health risks and challenges in medical treatments, creating a need for rapid and reliable drug screening technologies. This study introduces a cost-effective electrochemical paper-based device (ePAD) modified with functionalized bamboo-derived biochar (BCF) for the detection of paracetamol in substandard medicines. The sensor was fabricated using a custom 3D-printed stencil in PLA, designed for efficient production, and a 60:40 (m/m) graphite (GR) and glass varnish (GV) conductive ink, resulting in a robust and sensitive platform. The electroactive area of the ePAD/BCF sensor was determined as 0.37 cm2. Characterization via SEM and cyclic voltammetry (CV) verified its structural and electrochemical stability. The sensor demonstrated linear detection of paracetamol from 5.0 to 60.0 µmol L−1 with a detection limit of 3.50 µmol L−1. Interference studies showed high selectivity, with recoveries of over 90%, and the sensor successfully quantified paracetamol in commercial analgesic and anti-flu samples. This sustainable, bamboo-based ePAD offers a promising solution for rapid on-site pharmaceutical quality control, with significant potential to enhance drug screening accuracy.