In-Game Appearance

Tears Appearance

Item Type

Explosive Collectible

Pickup Quote

Explosive shots!


Collection Grid:

Recharge Time:

Treasure Room

Unlocked By:

A bottle of medicated syrup, with a label that reads "IPECAC" with a red warning label below.


Isaac appears sick.

Allows Isaac to fire projectiles from his mouth, causing explosive/poison damage. IPECAC shots are fired in an arc, making enemies difficult to hit without a proper Range stat.

IPECAC shots can hit like normal tears before exploding, doing normal tear damage.


  • This item is excellent for finding the Secret Room or the Super Secret Room, due to its infinite explosive potential.
  • Firing directly in front of an obstacle or an enemy is not recommended, as the shots will instantly explode at point blank and deal damage to Isaac.
  • Items that increase your range stat are not recommended with IPECAC, as they can make it harder to aim your shots.


  • Dr. Fetus - Gives Bombs a green color, with a greatly decreased fire rate. The damage of the bombs is NOT increased, and no poison effect will apply.
  • My Reflection: Causes the shots to come back toward Isaac. This interaction is not advisable, as the shots fired will almost always come back at Isaac and deal explosive damage to him.
  • Brimstone - Overrides IPECAC, but the damage of the beam is tripled, with an increased charge time.
  • Ouija Board, Dead Dove, Spirit Of The Night - No effect on IPECAC shots.
  • Mom's Knife - Overrides IPECAC.
  • The Inner Eye, Mutant Spider - Completely nullified by IPECAC, regardless of order picked up.


  • Spoon Bender, Sacred Heart, Telepathy for Dummies - Causes IPECAC shots to home in on enemies, making them easier to hit. However, this can be troublesome with monsters that chase Isaac, such as Globins.
  • Chocolate Milk - Stacks. Charging animation will not appear, but shots still deal increased damage.
  • Cat-O-Nine-Tails - Projectiles fly faster and farther.
  • Tough Love - Stacks. IPECAC shots can be large, green tooth shots that deal increased damage.
  • Technology - Overrides IPECAC, with tripled damage and decreased fire rate.
  • Technology 2 - Stacks with IPECAC
  • The Wafer - Due to the increased potential of accidentally hitting yourself with IPECAC shots, The Wafer is useful, as it decreases the damage of IPECAC shots to a half-heart.
  • A Lump Of Coal - Gains a moderate damage boost due to the long arc travel time.
  • Cupid's Arrow- IPECAC shots do not explode upon contact with enemies, making it safe to shoot enemies at point blank. The projectile will deal much less damage than the explosion, as it depends on Isaac's current tear damage. As such, it can be boosted with damage upgrades like the explosion itself.


  • IPECAC is a drug formerly used medically to induce vomiting (an emetic). This explains the appearance of the item (making Isaac appear sick) and its effects — causing Isaac to spit his projectiles.
  • The name of IPECAC is a short for Portuguese ipecacuanha, which roughly means small vomit leaves.


  • Using the Remote Detonator after launching an IPECAC projectile will trigger a second explosion in the same spot where the last projectile landed. Although the explosion is visible, no sound is emitted.
    • The resulting explosion from the Remote Detonator will cause damage to enemies, but less than the actual IPECAC projectile. This bug can be exploited to potentially double your fire rate if you use the Remote Detonator whilst the last shot is arching through the air.
    • This is hard to perform whilst moving, so it is recommended against slow moving/stationary enemies or bosses.
  • If IPECAC hits the player, the one tick poison effect takes place on Isaac. If you put down Best Friend during that time, you will take seven red hearts of damage (potentially killing you even through i-frames if you have red heart containers).