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

 * 20/20 - Fires two projectiles in a single shot.
 * Dr. Fetus - 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 - Blue flies do massive damage.
 * Host Hat - Isaac is immune to his projectiles.
 * Pyromaniac - Ipecac shots now heal Isaac.
 * Rotten Baby - Flies spawned by baby deal a large amount of damage.
 * Soy Milk - Decreases damage, but greatly increases rate of fire while still retaining the explosive effect.
 * 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 own tear.

Interactions

 * Anti-Gravity - 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 - 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. Isaac gains increased damage, decreased tears, and the poison effect.
 * Chocolate Milk - 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 tears. Isaac can also shoot a large number of tears by attacking repeatedly.
 * Cricket's Body - Main tear splits into four explosive splash tears. The splash tears can still damage Isaac.
 * Cursed Eye - Shoots charged Ipecac bombs like it would tears.
 * Dead Onion - Slows projectile and lowers range.
 * Piercing Tears - Tears will explode on enemy contact and therefore cannot pierce any enemies.
 * Epic Fetus - Missiles turn green and are poisonous. Damage greatly increases.
 * Fire Mind - Every Ipecac shot will leave behind a fire.
 * Ghost Pepper - 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.
 * Guppy Transformation: Ipecac shots now spawn blue flies on hit, both direct and indirect.
 * The Inner Eye - Shoots three Ipecac bombs.
 * Sad Bombs - Bombs explode into a six way Ipecac barrage.
 * Lead Pencil - A barrage of Ipecac tears are fired that land right next to Isaac, hitting him.
 * Lost Contact - Ipecac shots will explode on contact with enemy shots.
 * Loki's Horns - Ipecac will shoot in all 4 directions occasionally.
 * Magic Fingers - Greatly increases Magic Fingers' damage.
 * Mom's Eye - Occasionally shoots an explosive shot backwards. Not recommended, as self-damage is likely.
 * Mom's Knife - Knife turns green and poisons enemies.
 * Also adds +4 damage.
 * Monstro's Lung - Isaac coughs out a huge wave of Ipecac bombs.
 * Mr. Mega - Increases damage of the explosion.
 * Mutant Spider - Firing rate significantly reduced, but fires four Ipecac bombs at once.
 * 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.
 * Proptosis - Tear starts extremely large dealing massive damage and shrinks as it moves forward.
 * Pupula Duplex: Ipecac shots no longer explode on contact with rocks or walls, and the tears gain a crescent shape, increasing their hitbox.
 * Rubber Cement - Tears will bounce off walls and rocks and won't explode until they hit the ground.
 * Spirit of the Night - Ipecac shots no longer explode on contact with rocks or walls, making it very difficult to open secret doors.
 * Technology - Overridden by Technology, lose increased damage.
 * Technology 2 - Similar to Technology; Still Fires continuously but with greatly increased damage.
 * The Ludovico Technique - Tear explodes when killing an enemy and comes back to Isaac, but damage is reduced.
 * +4 damage bonus, no explosion.
 * Tough Love - Green teeth that will make the screen flicker.
 * Tiny Planet - Ipecac tears orbit around Isaac.

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
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 (Adjacent to start)