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Item icon
Item altar
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Character appearance
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Treasure Room Treasure Room
Greed mode only Treasure Room Treasure Room
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Added in Afterbirth(page 2, column 6, row 2)
Removed in Afterbirth(page 2, column 6, row 5)
Ipecac Defeat Mom's Heart 6 times

Ipecac is an unlockable passive item.

Effects[edit | edit source]

  • 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)
  • Tear size multiplier: 0.4x
  • Added in Afterbirth This item belongs to the Bob set. Collecting three items from this set will transform Isaac into Bob.

Notes[edit | edit source]

  • 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.
  • Enemies within the blast radius of an Ipecac explosion will also be poisoned.
  • The damage boost mitigates the very small tear size multiplier.
  • Ipecac's damage bonus does not apply to Burn or Poison fully; only +4 is applied to their damage per tick.
  • Character damage multipliers do not apply to Ipecac's flat bonus.
  • 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 to using it on a Crawl Space wall.
  • The range of the explosion is a circle roughly 3 blocks in diameter, regardless of damage.

Synergies[edit | edit source]

  • Chocolate Milk Chocolate Milk: Charged up Ipecac deals expectedly high damage. Rapid-fire can be used against weaker enemies or to clear obstacles when necessary.
  • Cricket's Head Cricket's Head / Eve's Mascara Eve's Mascara / Magic Mushroom Magic Mushroom: The damage multipliers from these items apply to Ipecac's +40 bonus, unlike others.
  • Dr. Fetus Dr. Fetus: Bombs explode on contact, do no damage to Isaac and become Bob's Curse bombs.
    • Dr. Fetus + Monstro's Lung: Renders Isaac no longer immune to his shots, also they will explode as soon as Isaac shoots.
  • Epic Fetus Epic Fetus: Missiles turn green and are poisonous. Damage greatly increases as the flat damage bonus stacks with Epic Fetus' explosive multiplier.
  • Added in Afterbirth †Haemolacria Haemolacria: Tear delay is increased by 1/3 compared to either of the items on their own, but Isaac now fires Ipecac shots that releases poisonous, high-damage but non-explosive split tears on impact.
  • Mom's Knife Mom's Knife: Knife turns green, may poison enemies, and removes Ipecac's damage increase.
    • Added in Afterbirth † Also adds +4 damage.
  • Monstro's Lung Monstro's Lung: Isaac fires a barrage of Ipecac shots, with no increase in charge time compared to Monstro's Lung alone.
  • Mysterious Liquid Mysterious Liquid: Leaves a massive pool of creep on the floor on impact.
  • Added in AfterbirthTractor Beam Tractor 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 tear.

Interactions[edit | edit source]

  • Bloody Lust Bloody Lust / Added in AfterbirthCrown of Light Crown of Light / Polyphemus Polyphemus / Proptosis Proptosis / Sacred Heart Sacred Heart: The damage multipliers from these items do not apply to Ipecac's +40 bonus, resulting in much lower damage increase than expected.
  • Brimstone Brimstone: 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.
  • Cricket's Body Cricket's Body: The main tear splits into four explosive splash tears. The splash tears can still damage Isaac.
  • Death's Touch Death's Touch: Although damage is increased, the tears' hitbox also grows larger which may be detrimental.
  • Added in Afterbirth †Flat Stone Flat Stone: The Ipecac shots cause full-damage explosions instead of lesser splash damage when they bounce off the floor, though they can also harm Isaac.
  • 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 Pepper: If a fire is generated at the same time as an Ipecac shot, the Ipecac shot will explode instantly.
  • Added in AfterbirthGlass Cannon Glass Cannon: As the Glass Cannon tears are so large, even a modest damage increase or a single tear size increasing item is likely to render the tear unable to damage enemies.
  • 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.
  • Added in Afterbirth †Jacob's Ladder Jacob's Ladder Sparks of electricity shoot out only when hitting a wall.
  • Added in Afterbirth †Little Horn Little Horn: If an Ipecac shot also happens to have the Little Horn effect, after destroying an enemy, it loses its explosive property and effectively is just a normal Little Horn tear.
  • Lost Contact Lost Contact: Ipecac shots will explode on contact with enemy shots.
  • The Ludovico Technique The Ludovico Technique: Tear damage is increased by 4, explodes when killing an enemy, and comes back to Isaac.
    • Added in Afterbirth † +4 damage bonus, no explosion.
  • Mom's Eye Mom's Eye / Loki's Horns Loki's Horns: Occasionally shoots backwards or in all 4 directions, with high risk of self-damage.
  • The Parasite The Parasite: 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 still explode on enemy contact, nullifying piercing.
  • Rubber Cement Rubber Cement: Tears will bounce off walls and rocks and won't explode until they hit the ground. Not recommended, as self-damage is likely.
  • Spectral tears: Ipecac shots no longer explode on contact with obstacles or walls, making accidental self-damage less likely but it's more difficult to open secret doors.
  • Added in AfterbirthTech X Tech X: The laser ring becomes poisonous and gains +4 damage.
  • Technology Technology: Overridden by Technology.
    • Added in Afterbirth † +4 damage bonus, poisonous laser.
  • Technology 2 Technology 2: The +40 damage bonus is not affected by the Technology 2 multiplier making the laser very high powered, but only every other Ipecac shot is fired.
  • Added in Afterbirth †Technology Zero Technology Zero: High fire rate needed for explosive shots to be connected.
  • Tiny Planet Tiny Planet: Ipecac tears orbit around Isaac for a very long time. They land far enough to not cause self-damage, but that can be relied on only if Isaac is not moving and do not hit enemies.
  • Added in Afterbirth †Trisagion Trisagion: The explosive tears from Ipecac are replaced with Trisagion's beams that travel through obstacles and have a piercing effect dealing 33% of regular damage to enemies they come in contact with, but won't explode on hit. The Ipecac explosion will happen once the beam runs out of range or hits a wall and will deal damage equal to Isaac's damage.

In-game Footage[edit | edit source]

Unlockable Achievements[edit | edit source]

Trivia[edit | edit source]

  • "Ipecac" is a shortened name for syrup of ipecac, a powerful emetic (a substance used to induce vomiting). This name is itself derived from a shortening of the source plant's name, Ipecacuanha.
  • If Isaac's damage is above 100, Ipecac's explosions will shake the screen. This is just a visual effect.
  • This item is used in Suicide King (challenge #7).

Seeds[edit | edit source]

 PC  2Q6M EEZQ (First floor Treasure Room)

 PC  BK3W 93F4 (Treasure Room adjacent to spawn)

 PC  NNH2 XPNP (Treasure Room adjacent to spawn)

 PC  Normal mode only Q47Z GX3W (Treasure Room adjacent to spawn)

 PC  C139 L97X (Treasure Room adjacent to spawn)

 PC  Hard mode only 8R72 734X (Treasure Room, 2 rooms left of spawn)

 PS4  HYDG 0PPY (First Treasure Room)

 PS4  Added in Afterbirth † 0ACX C07T (First Treasure Room)

 Vita  3N3B BFWZ (Treasure Room adjacent to spawn)

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