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Item icon
Item altar

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Character appearance
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Item Pool Treasure Room.png Treasure Room
Added in AfterbirthGreed mode onlyItem Pool Treasure Room.png Treasure Room
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Added in Afterbirth (page 2, column 6, line 2)
Removed in Afterbirth (page 2, column 6, line 5)
Ipecac Defeat Mom's Heart 6 timesIpecacIpecac

Ipecac is an unlockable passive item.


  • Replaces tears with explosive and poisoning projectiles fired in an arc.
  • Tears down - (Delay * 2) + 10
  • +13 Shot Height
  • +40 flat damage (See Effective Damage)
  • Added in Afterbirth This item belongs to the Bob
    Bob App.png
  • Isaac gains a green trail of poisonous creep.
  • set. Collecting three items from this set will transform Isaac into Bob.


  • As Ipecac's explosion range does not scale with tear size, with enough tear size increasing items (e.g. Death's Touch), it can become nearly impossible to hit enemies with Ipecac's explosions.
  • Ipecac's flat damage upgrade does not increase tear size like standard damage upgrades.
  • Ipecac's damage bonus does not apply to Burn or Poison fully; only +4 is applied to their damage per tick.
  • Using Ipecac in a Crawl Space will cause the tear to bounce off the ceiling, bounce off the floor at a low height, and eventually explode. The same applies with using it on a Crawl Space wall.


  • 20/20 20/2020 20 Icon.pngGrants double shot.: Fires two projectiles in a single shot.
  • Dr. Fetus Dr. FetusDr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.: Bombs explode on contact, do no damage to Isaac and become Bob's Curse bombs. Mixing this synergy with Monstro's Lung renders Isaac no longer immune to his own shots, also they will explode as soon as you shoot.
  • Guppy's Head Guppy's HeadGuppy's Head Icon.png1 roomsSpawns 2-4 blue flies to damage enemies.: Blue flies do massive damage.
  • Added in AfterbirthHost Hat Host HatHost Hat Icon.pngA host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.: Isaac is immune to his projectiles.
  • Pyromaniac PyromaniacPyromaniac Icon.pngIsaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.: Ipecac shots now heal Isaac.
  • Rotten Baby Rotten BabyRotten Baby Icon.pngA familiar that spawns blue flies.: Flies spawned by baby deal a large amount of damage.
  • Soy Milk Soy MilkSoy Milk Icon.pngTears shrink and do much less damage, but fire in very rapid succession.: Decreases damage, but greatly increases rate of fire while still retaining the explosive effect.
  • Added in AfterbirthTractor Beam Tractor BeamTractor Beam Icon.pngIsaac emits a beam from his face. Isaac's tears travel in the path of the beam.: The Ipecac tear will always travel forwards along the beam, even if Isaac is moving forward as well. This makes it less likely for Isaac to get damaged by his own tear.


  • Anti-Gravity Anti-GravityAnti-Gravity Icon.png-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.: While holding down the fire button, Isaac will shoot Ipecac tears that float around him and after a few seconds it will start releasing the tears one by one. You can also release the fire button to shoot multiple tears at once.
  • Brimstone BrimstoneBrimstone Icon.pngTears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.: Blood beam now does poison damage. The character doesn't gain the Damage Up or Tears Down effects.
    • Added in Afterbirth † Isaac shoots Ipecac tears while charging Brimstone. Both Brimstone and Ipecac shots modify Isaac's damage and tear delay stat, meaning that Ipecac fires slower and Brimstone charges slower, but Brimstone does an extra 40*13 damage. Take care to pre-charge Brimstone so that the Ipecac shot is on cooldown as Isaac enters a room. This interaction also applies to Azazel's mini Brimstone.
  • Chocolate Milk Chocolate MilkChocolate Milk Icon.pngGrants charged tears that deal greater damage when fully charged.: Ipecac can now charge. When it is fully charged, Isaac shoot a very big Ipecac tear that does very high damage. Without charging the shot, Isaac shoots a very small Ipecac tear, similar to Soy Milk Soy MilkSoy Milk Icon.pngTears shrink and do much less damage, but fire in very rapid succession. tears. Isaac can also shoot a large number of tears by attacking repeatedly.
  • Cricket's Body Cricket's BodyCricket's Body Icon.pngGrants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.: Main tear splits into four explosive splash tears. The splash tears can still damage Isaac.
  • Cursed Eye Cursed EyeCursed Eye Icon.pngGrants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.: Shoots charged Ipecac bombs like it would tears.
  • Dead Onion Dead OnionDead Onion Icon.pngGrants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.: Slows projectile and lowers range.
  • Epic Fetus Epic FetusEpic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.: Missiles turn green and are poisonous. Damage greatly increases.
  • Fire Mind Fire MindFire Mind Icon.pngGrants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.: Every Ipecac shot will leave behind a fire.
  • Added in Afterbirth †The Forgotten: The ghost form uses Ipecac as normal. The skeleton form's melee attacks become poisonous and explosive with +4 flat damage; he cannot be hurt by the blasts, but is pushed back by them. The charged boomerang attack is only poisonous.
  • Added in Afterbirth †Ghost Pepper Ghost PepperGhost Pepper Icon.pngAdds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.: If a fire is generated at the same time as a Ipecac shot, the Ipecac shot will explode instantly.
  • Guppy Transformation: Blue flies are no longer spawned on hit.
    • Added in Afterbirth Ipecac shots now spawn blue flies on hit, both direct and indirect.
  • The Inner Eye The Inner EyeThe Inner Eye Icon.pngGrants triple shot but decreases tears.: Shoots three Ipecac bombs.
  • Added in Afterbirth †Lead Pencil Lead PencilLead Pencil Icon.pngAfter every 15 tears fired, Isaac will fire a high-damage cluster of tears.: A barrage of Ipecac tears are fired that land right next to Isaac, hitting him.
  • Lost Contact Lost ContactLost Contact Icon.pngEvery tear has a small shield which will allow it to block one enemy projectile.: Ipecac shots will explode on contact with enemy shots.
  • Loki's Horns Loki's HornsLoki's Horns Icon.pngGives a random chance for projectiles to fire in all 4 cardinal directions.: Ipecac will shoot in all 4 directions occasionally.
  • The Ludovico Technique The Ludovico TechniqueThe Ludovico Technique Icon.pngInstead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.: Tear explodes when killing an enemy and comes back to Isaac, but damage is reduced.
    • Added in Afterbirth † +4 damage bonus, no explosion.
  • Magic Fingers Magic FingersMagic Fingers Icon.pngUnlimitedFor 1 coin, damages all enemies in the room.: Greatly increases Magic Fingers' damage.
  • Mom's Eye Mom's EyeMom's Eye Icon.pngAllows Isaac to fire tears from the back of his head.: Occasionally shoots an explosive shot backwards. Not recommended, as self-damage is likely.
  • Mom's Knife Mom's KnifeMom's Knife Icon.pngIsaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.: Knife turns green and poisons enemies.
    • Added in Afterbirth † Also adds +4 damage.
  • Monstro's Lung Monstro's LungMonstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.: Isaac coughs out a huge wave of Ipecac bombs.
  • Mr. Mega Mr. MegaMr. Mega Icon.pngGives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.: Increases damage of the explosion.
  • Mutant Spider Mutant SpiderMutant Spider Icon.pngGrants quadruple shot but decreases tears.: Firing rate significantly reduced, but fires four Ipecac bombs at once.
  • The Parasite The ParasiteThe Parasite Icon.pngIsaac's tears split in two when they hit something.: The Ipecac tear will spawn two smaller explosive tears when it collides with a solid object, but not with an enemy. These tears can spawn tears on their own as well, potentially leading to huge chain reactions.
  • Piercing Tears: Tears will explode on enemy contact and therefore cannot pierce any enemies.
  • Proptosis ProptosisProptosis Icon.pngTears start out massive with high damage, and then shrink down and become weaker over a short range.: Tear starts extremely large, dealing massive damage, and shrinks as it moves forward.
  • Added in AfterbirthPupula Duplex Pupula DuplexPupula Duplex Icon.pngTransforms Isaac's tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).: Ipecac shots no longer explode on contact with rocks or walls, and the tears gain a crescent shape, increasing their hitbox.
  • Rubber Cement Rubber CementRubber Cement Icon.pngTears bounce off walls, enemies, and environmental objects.: Tears will bounce off walls and rocks and won't explode until they hit the ground.
  • Sad Bombs Sad BombsSad Bombs Icon.png+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.: Bombs explode into a six way Ipecac barrage.
  • Spirit of the Night Spirit of the NightSpirit of the Night Icon.pngGrants spectral tears and flight.: Ipecac shots no longer explode on contact with rocks or walls, making it very difficult to open secret doors.
  • Technology TechnologyTechnology Icon.pngReplaces tears with a piercing laser with unlimited range.: Overridden by Technology, lose increased damage.
    • Added in Afterbirth † +4 damage bonus, poison laser.
  • Technology 2 Technology 2Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.: Similar to Technology; still fires continuously but with greatly increased damage.
  • Added in Afterbirth †Technology Zero Technology ZeroTechnology Zero Icon.pngConnects Isaac's tears with electricity that can damage enemies.: High fire rate needed for explosive shots to be connected.
  • Tiny Planet Tiny PlanetTiny Planet Icon.pngRange up and makes shot tears revolve around Isaac until they drop.: Ipecac tears orbit around Isaac.
  • Tough Love Tough LoveTough Love Icon.pngAdds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.: Fires green teeth that will make the screen shake.

In-game Footage

Unlockable Achievements


  • "Ipecac" is a shortened name for syrup of ipecac, a powerful emetic (substance used to induce vomiting). This name is itself derived from a shortening of the source plant's name, Ipecacuanha.
  • This item is used in Challenge #7 (Suicide King).


 PC  2Q6M EEZQ (First floor treasure room)

 PC  BK3W 93F4 (treasure room adjacent to spawn)

 PC  NNH2 XPNP (treasure room adjacent to spawn)

 PC  Q47Z GX3W (treasure room adjacent to spawn - Normal mode)

 PC  C139 L97X (treasure room adjacent to spawn)

 PS4  HYDG 0PPY (First treasure room)

 Vita  3N3B BFWZ (Treasure room adjacent to spawn)