There are a few creatures with multiple heads in Dungeons & Dragons. The Ettin is a two headed giant. The Hydra usually starts with five heads and gets messier from there. Tiamat, an evil dragon goddess, also carries five heads.
The Runespoor is therefore not an impossible D&D monster, but the fact that the heads are so different requires some extra thought. The Ettin heads are often very different personalities but do not perform different functions that would effect their stats. The hydra heads all have a straightforward chomp. The Tiamat heads have unique breath weapons but, again, that’s where the complications end.
The Runespoor heads do very particular things, with a distinct personality. On top of that, Fantastic Beasts specifies that the creature often kills one of its own heads. This snake is an odd duck.
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