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(in Afterbirth † and Repentance)

Haemolacria is an unlockable passive item added in The Binding of Isaac: Afterbirth † (Booster Pack #4).

Effects[ | ]

  • Tears are fired in an arc. Upon hitting the floor, an obstacle, or an enemy they burst into smaller tears in all directions.
    • The number of burst tears is random between 6-11 and they have equal chance.
    • The scattered tears deal random damage that is 50-83.33% of the main tear. On average, they deal 66% damage.
  • Tears down: Tear Delay × 2 + 10
    • (in Repentance) The tear delay adjustment is applied after fire rate downs, before fire rate ups.
  • (except in Repentance) 1.31~x damage multiplier.
  • (in Repentance) +1 damage and 1.5x damage multiplier.
  • (in Repentance) Range down: 0.8x range multiplier.
  • The main tear has a roughly 1.71x size multiplier.

Notes[ | ]

  • Higher shot speed lowers the arc of the main shot, whereas lower speed heightens it, resulting in a very minor change in effective range.
    • The split tears are affected normally by shot speed.
  • (except in Repentance) The tear falling speed stat is entirely ignored for both the main shot and the split tears.

Synergies[ | ]

  • Collectible Brimstone iconBrimstone: Haemolacria has priority. +20 Tear Delay after Haemolacria tears down, instead of Brimstone tears down. The main tears burst into 4-7 brimstone beams instead of smaller tears. The beams deal 100% damage per tick.
    • This does not apply to Character Azazel iconAzazel/ Character Tainted Azazel iconTainted Azazel's default brimstone beam, which is overwritten but with no special effects.
    • (in Repentance) If the powered-up version is acquired through another Brimstone or through (in Repentance)Collectible Sulfur iconSulfur, the 1.2x damage multiplier is overriden by Haemolacria's own 1.5x damage multiplier. The beams' width doubles.
    • Brimstone + Collectible Chocolate Milk iconChocolate Milk: The brimstone beams deal 100% damage regardless the charge. Chocolate Milk allows for rapid firing of Haemolacria tears, giving Isaac the ability to flood the room with Brimstone lasers.
    • (in Repentance) Brimstone + Collectible Technology iconTechnology: The lasers coil the beams, which is purely visual, and Technology does not grant 1.5x damage multiplier.
    • Dangerous when combined with Collectible Ipecac iconIpecac
  • (in Repentance)Collectible Berserk! iconBerserk! / Character The Forgotten iconThe Forgotten / Character Tainted Forgotten iconTainted Forgotten: Burst effect occurs on each enemy hit. It also increases the size of the club, similar to Collectible Polyphemus iconPolyphemus. The throw is unaffected and does not scatter blood tears.
  • Collectible Chocolate Milk iconChocolate Milk: Completely charged shots and their burst tears are larger and deal higher damage than normal. Chocolate Milk also allows low-damage Haemolacria shots to be fired rapidly.
    • (except in Repentance) Increased tear delay.
  • Collectible Compound Fracture iconCompound Fracture / Collectible The Parasite iconThe Parasite: The main tears can split as they burst upon hitting an obstacle, or an enemy, but not upon hitting the floor. The split tears can burst, but burst tears from main tears do not split.
  • Collectible Cricket's Body iconCricket's Body: Main tears can split as they burst upon hitting the floor, an obstacle, or an enemy. The split tears can burst, but burst tears from main tears do not split.
    • (in Repentance) Haemolacria's x0.8 range multiplier does not stack with Cricket's Body's own x0.8 range multiplier.
  • Collectible Dead Eye iconDead Eye: Both the main tear and the burst tears can increase the damage bonus, but missing the burst tears won't reset it.
  • Collectible Dr. Fetus iconDr. Fetus: Haemolacria has priority. +10 Tear Delay after Haemolacria tears down, instead of Dr. Fetus tears down. The main tear is reminiscent of a bomb and scatters into 3-5 bombs that explode simultaneously. The split bombs deal half of Dr. Fetus' damage calculation based on the main tear's damage.
    • (in Repentance) Double Dr. Fetus: Isaac fires one additional Haemolacria tear, essentially a multi-shot effect, without stat change.
    • Dr. Fetus + Collectible Sad Bombs iconSad Bombs: Sad bombs from Haemolacria tears shoot 10 Haemolacria tears, which then scatters into bombs without Sad Bombs' property.
  • Collectible Ipecac iconIpecac: Tear delay is increased by 1/3 compared to either of the items on their own, but Isaac now fires Ipecac shots that release poisonous, high-damage but non-explosive split tears on impact.
    • (in Repentance) Haemolacria's x0.8 range multiplier does not stack with Ipecac's own x0.8 range multiplier. Can be dangerous when combined with Collectible Brimstone iconBrimstone.
  • Collectible Lachryphagy iconLachryphagy: Main tears can feed on other main tears or burst tears while burst tears cannot feed. The main tears will burst into 8 tears that have Haemolacria's burst effect upon impact or being fed enough. If they impact too soon after being fired or hit an enemy, they will burst into Haemolacria's burst tears. Lachryphagy's burst tears do not benefit from Haemolacria's synergies with other items, such as Collectible Brimstone iconBrimstone or Collectible Tech X iconTech X.
  • Collectible Lead Pencil iconLead Pencil: Fires 12 Haemolacria tears, all of which will burst.
  • Collectible Mom's Knife iconMom's Knife: Haemolacria tears fire while Mom's Knife is charging.
    • (in Repentance) Mom's Knife has priority. +10 Tear Delay, instead of Haemolacria tears down.
    • Mom's Knife + Character Lilith iconLilith: Mom's Knife overrides.
  • Collectible Monstro's Lung iconMonstro's Lung: Monstro's Lung has priority. Fire rate is reduced. Fires 8 Haemolacria tears, all of which will burst.
  • Collectible My Reflection iconMy Reflection: Range becomes extremely high, making Haemolacria tears follow Isaac for a long time before hitting the ground. Burst tears do not have a boomerang effect.
  • Collectible Proptosis iconProptosis: Effects combine to create large tears that bounce off each other and burst into smaller, standard tears that are not effected by Proptosis.
  • Collectible Technology iconTechnology: Haemolacria has priority. Fires arcing tears that release Technology lasers upon bursting. The lasers deal 100% Isaac's Damage.
    • (in Repentance) Double Technology: Isaac fires one additional Haemolacria tear, essentially a multi-shot effect.
  • Collectible Tech X iconTech X: Haemolacria has priority. The tears burst into 3-5 Tech X rings on impact. The sizes of the rings are various, but they deal 100% Isaac's Damage.
    • (in Repentance) Double Tech X: Isaac fires one additional Haemolacria tear, essentially a multi-shot effect.
  • Collectible Trisagion iconTrisagion: Both Trisagion and Haemolacria fire at the same time, Haemolacria does not keep spectral tears despite its tears sprite change but the arced tear keeps piercing.
    • (in Repentance) Haemolacria becomes one big Trisagion beam that splits into more beams when it reaches its max range.

Interactions[ | ]

  • Character Azazel iconAzazel: Haemolacria overrides Azazel's Brimstone.
  • (in Repentance)Collectible The Book of Belial iconThe Book of Belial + Collectible Blood of the Martyr iconBlood of the Martyr/Collectible Cricket's Head iconCricket's Head/Collectible Magic Mushroom iconMagic Mushroom: Haemolacria's 1.5x damage multiplier stacks with these items' own 1.5x damage multipliers as expected.
  • (in Repentance)Collectible C Section iconC Section: C Section has priority. +4 Tear Delay, instead of Haemolacria tears down. Fetuses explode into a burst of tears when they hit the ground.
  • Collectible Epic Fetus iconEpic Fetus: Epic Fetus has priority. +10 Tear Delay, instead of Haemolacria tears down.
  • Collectible Flat Stone iconFlat Stone: At the base range, the main tear bounces once, releasing burst tears which do not bounce, then bursts normally. At a high range, the main tear can bounce multiple times.
  • Collectible Godhead iconGodhead: Main tear retains all effects, but burst tears do not.
    • (in Repentance) The main tear has the damaging aura as well as the burst tears.
  • Haemolacria: Additional copy of this item, such as from Collectible Diplopia iconDiplopia / Collectible Crooked Penny iconCrooked Penny, grants +1 damage instead of normal stat changes.
  • Collectible Holy Light iconHoly Light: The main tear can be a holy tear and bursts normally in addition to the light beam. Burst tears have an independent chance of being holy tears.
    • (in Repentance) The burst tears inherit the effect from the main tear. They do not have an independent chance.
  • Collectible Kidney Stone iconKidney Stone: Overridden by Haemolacria. Only stat changes apply.
    • (in Repentance) Works as expected. The kidney stone also bursts when it reaches its max range.
  • Collectible The Ludovico Technique iconThe Ludovico Technique: Overridden by Haemolacria, provides piercing.
  • Collectible Mysterious Liquid iconMysterious Liquid: Only the main tear will leave creep.
    • (in Repentance) Both main and burst tears spawn creep.
  • (in Repentance)Collectible Number One iconNumber One: Not recommended. Unlike other similar items, Haemolacria's x0.8 range multiplier does stack with Number One's own x0.8 range multiplier, thus drastically reducing range.
  • Piercing tears / Spectral tears: The main tear gains these effects, but the burst tears don't inherit them.
    • (in Repentance) Burst tears inherit these effects.
  • Collectible Polyphemus iconPolyphemus: Stat changes applied as normal. The main tear gains the semi-piercing ability and may not burst when hitting a weaker enemy. Burst tears do not semi-pierce.
    • (in Repentance) Burst tears do semi-pierce.
  • Collectible Pop! iconPop!: Tears no longer arc, but will still burst when hitting an obstacle or stopping and falling to the ground. Burst tears do not bounce off of each other.
  • (in Repentance)Collectible Sharp Key iconSharp Key: Split tears from thrown keys are normal tears.
  • Collectible Sinus Infection iconSinus Infection: If the main tear is a booger, it will get stuck and not burst on hitting an enemy. Split tears have an independent chance of being booger tears.
    • (in Repentance) The burst tears inherit the effect from the main tear. They do not have an independent chance.
  • (in Repentance)Collectible Spirit Sword iconSpirit Sword: Spirit Sword has priority. +10 Tear Delay, instead of Haemolacria tears down. The projectiles from the sword arc and burst.
  • Collectible Technology Zero iconTechnology Zero: Only main tears can be connected.
    • (in Repentance) Main tears and bursts can be connected via electricity.
  • Collectible Tractor Beam iconTractor Beam: The main tear follows the beam, but the burst spreads normally.

In-game Footage[ | ]

Gallery[ | ]

Trivia[ | ]

  • Haemolacria is based on this Steam Workshop item by HiHowAreYou, originally known as Water Balloon.
  • Haemolacria is a rare condition that causes people to produce tears that are composed of blood.
  • When Character Tainted ??? iconTainted ??? uses Haemolacria, the tears will be black instead of red. This is purely cosmetic, and is probably a reference to how stools containing dried blood are often black.

Bugs[ | ]

Bug Bug! (except in Repentance) When using Character The Forgotten iconThe Forgotten's melee attack with both Collectible Jacob's Ladder iconJacob's Ladder and Haemolacria, the sparks caused by splattered tears will hurt the player. (Video clip)
Bug Bug! (except in Repentance) Using Collectible Mom's Knife iconMom's Knife and Collectible Marked iconMarked with Haemolacria will cause it to only fire towards the center of room, using the fire buttons will barely move the Marked icon; while Mom's Knife will be unusable and locked to the right.


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