Hemoptysis

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(in Repentance and Repentance+)

Hemoptysis is an unlockable passive item added in The Binding of Isaac: Repentance.

Effects

  • Double-tapping the fire button causes Isaac to sneeze blood, dealing damage to enemies in front of him. The sneeze deals damage equal to 1.5x Isaac's damage, knocking enemies and projectiles back. Knocked back enemies take 10 additional damage if they hit a wall or obstacle. If the knocked back enemies hit other enemies, those additional enemies take 10 damage.
    • The sneeze has a cooldown of 1 second.
    • The reflected projectiles deal 6 damage to enemies if it would have caused Isaac half a heart of damage, and 7 damage if it would have caused Isaac a full heart damage.
  • The sneeze applies a curse to enemies. Enemies under the curse will take more damage from Collectible Brimstone icon.pngBrimstone-like laser attacks and violently explode on death, damaging and spreading the curse to nearby enemies. Any enemies spawned by those under the curse will also be cursed.

Notes

  • Character Tainted Azazel icon.pngTainted Azazel begins with an inherent version of Hemoptysis that allows him to deal full damage to cursed enemies.
    • The innate sneeze ability is entirely separate from Hemoptysis, and so the sneeze can be triggered twice in quick succession. However, triggering the sneeze from Hemoptysis will cancel Tainted Azazel's brimstone charge, meaning that this item is largely ineffective as this character.
  • The sneeze's range is affected by the shot speed stat, and not by the range stat itself.
  • The sneeze can push Bomb.pngBombs, pickups and enemy shots.
  • The collision damage can be used to damage Host.pngHosts while their skulls are lowered.
  • Brimstone lasers shot by enemies who are not charmed, such as Boss Monstro II ingame.pngMonstro II, will also do increased damage to cursed enemies
  • Collectible Revelation icon.pngRevelation's charged attack will not deal increased damage to cursed enemies

Synergies

  • Collectible Fire Mind icon.pngFire Mind: The sneeze will still set enemies on fire, but not cause explosions, similar to its interaction with Collectible Brimstone icon.pngBrimstone.
  • Collectible Loki's Horns icon.pngLoki's Horns: Chance to sneeze in all cardinal directions.
  • Collectible Monstro's Lung icon.pngMonstro's Lung: Multiple sneezes are applied around the character.
  • Collectible The Wiz icon.pngThe Wiz: Shoots two sneezes diagonally instead of one straight forward.
  • Collectible Ipecac icon.pngIpecac: The sneeze causes an explosion. The explosion deals additional damage equal to 3x Isaac's damage +10 and will not hurt Isaac.

In-game Footage

Trivia

  • Hemoptysis is the medical term for coughing up blood.