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)
- This item belongs to the Bob set. Collecting three distinct 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.
- 20/20Grants double shot.: Fires two projectiles in a single shot.
- Dr. FetusTears 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 HeadSpawns 2-4 blue flies to damage enemies.: Blue flies do massive damage.
- Host HatA 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.
- PyromaniacIsaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.: Ipecac shots now heal Isaac.
- Rotten BabyA familiar that spawns blue flies.: Flies spawned by baby deal a large amount of damage.
- Soy MilkTears 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.
- Tractor BeamIsaac 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-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.
- BrimstoneTears 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.
- 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 MilkGrants 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 MilkTears 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 BodyGrants -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 EyeGrants 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 OnionGrants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.: Slows projectile and lowers range.
- Epic FetusIsaac'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 MindGrants 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.
- 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.
- Ghost PepperAdds 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.
- Ipecac shots now spawn blue flies on hit, both direct and indirect.
- The Inner EyeGrants triple shot but decreases tears.: Shoots three Ipecac bombs.
- Lead PencilAfter 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 ContactEvery 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 HornsGives a random chance for projectiles to fire in all 4 cardinal directions.: Ipecac will shoot in all 4 directions occasionally.
- The Ludovico TechniqueInstead 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.
- +4 damage bonus, no explosion.
- Magic FingersFor 1 coin, damages all enemies in the room.: Greatly increases Magic Fingers' damage.
- Mom's EyeAllows 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 KnifeIsaac'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.
- Also adds +4 damage.
- Monstro's LungIncreases 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. MegaGives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.: Increases damage of the explosion.
- Mutant SpiderGrants quadruple shot but decreases tears.: Firing rate significantly reduced, but fires four Ipecac bombs at once.
- The ParasiteIsaac'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.
- ProptosisTears 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.
- Pupula DuplexTransforms 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 CementTears 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+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 NightGrants spectral tears and flight.: Ipecac shots no longer explode on contact with rocks or walls, making it very difficult to open secret doors.
- TechnologyReplaces tears with a piercing laser with unlimited range.: Overridden by Technology, lose increased damage.
- +4 damage bonus, poison laser.
- Technology 2Decreases 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.
- Tiny PlanetRange up and makes shot tears revolve around Isaac until they drop.: Ipecac tears orbit around Isaac.
- Tough LoveAdds 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.
- "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).
2Q6M EEZQ (First floor treasure room)
BK3W 93F4 (treasure room adjacent to spawn)
NNH2 XPNP (treasure room adjacent to spawn)
Q47Z GX3W (treasure room adjacent to spawn - Normal mode)
C139 L97X (treasure room adjacent to spawn)
HYDG 0PPY (First treasure room)
3N3B BFWZ (Treasure room adjacent to spawn)