Ipecac

Ipecac is an unlockable passive item.

Effects

 * 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)

Synergies

 * : Fires two projectiles in a single shot.
 * : 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.
 * : Blue flies do massive damage.
 * : Isaac is immune to his projectiles.
 * : Ipecac shots now heal Isaac.
 * : Flies spawned by baby deal a large amount of damage.
 * : Decreases damage, but greatly increases rate of fire while still retaining the explosive effect.
 * : 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.

Interactions

 * : 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.
 * : 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.
 * : 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 tears. Isaac can also shoot a large number of tears by attacking repeatedly.
 * : Main tear splits into four explosive splash tears. The splash tears can still damage Isaac.
 * : Shoots charged Ipecac bombs like it would tears.
 * : Slows projectile and lowers range.
 * : Missiles turn green and are poisonous. Damage greatly increases.
 * : 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.
 * : 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.
 * : Shoots three Ipecac bombs.
 * : A barrage of Ipecac tears are fired that land right next to Isaac, hitting him.
 * : Ipecac shots will explode on contact with enemy shots.
 * : Ipecac will shoot in all 4 directions occasionally.
 * : Tear explodes when killing an enemy and comes back to Isaac, but damage is reduced.
 * +4 damage bonus, no explosion.
 * : Greatly increases Magic Fingers' damage.
 * : Occasionally shoots an explosive shot backwards. Not recommended, as self-damage is likely.
 * : Knife turns green and poisons enemies.
 * Also adds +4 damage.
 * : Isaac coughs out a huge wave of Ipecac bombs.
 * : Increases damage of the explosion.
 * : Firing rate significantly reduced, but fires four Ipecac bombs at once.
 * : 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.
 * : Tear starts extremely large, dealing massive damage, and shrinks as it moves forward.
 * : Ipecac shots no longer explode on contact with rocks or walls, and the tears gain a crescent shape, increasing their hitbox.
 * : Tears will bounce off walls and rocks and won't explode until they hit the ground.
 * : Bombs explode into a six way Ipecac barrage.
 * : Ipecac shots no longer explode on contact with rocks or walls, making it very difficult to open secret doors.
 * : Overridden by Technology, lose increased damage.
 * +4 damage bonus, poison laser.
 * : Similar to Technology; still fires continuously but with greatly increased damage.
 * : Ipecac tears orbit around Isaac.
 * : Fires green teeth that will make the screen shake.

Trivia

 * "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).

Seeds
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)