Binding of Isaac: Rebirth Wiki

(in 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 iconBrimstone-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 iconTainted 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 BombBombs, pickups and enemy shots.
  • The collision damage can be used to damage HostHosts while their skulls are lowered.
  • Brimstone lasers shot by enemies who are not charmed, such as Boss Monstro II ingameMonstro II, will also do increased damage to cursed enemies
  • Collectible Revelation iconRevelation's charged attack will not deal increased damage to cursed enemies

Synergies[ | ]

  • Collectible Fire Mind iconFire Mind: The sneeze will still set enemies on fire, but not cause explosions, similar to its interaction with Collectible Brimstone iconBrimstone.
  • Collectible Loki's Horns iconLoki's Horns: Chance to sneeze in all cardinal directions.
  • Collectible Monstro's Lung iconMonstro's Lung: Multiple sneezes are applied around the character.
  • Collectible The Wiz iconThe Wiz: Shoots two sneezes diagonally instead of one straight forward.
  • Collectible Ipecac iconIpecac: 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.