Binding of Isaac: Rebirth Wiki

Added in Afterbirth

Placebo is an activated item added in The Binding of Isaac: Afterbirth.


  • Mimics the effect of Isaac's held pill, like Blank Card Blank Card does with cards and Added in RepentanceClear Rune Clear Rune does with runes.
    • Does not consume Isaac's held pill.
    • Does not mimic cards or runes.

Recharge time Added in Repentance[]

In Repentance, Placebo's recharge time changes depending on the pill Isaac was holding when he used it. This is a list of the following recharge times the item can have:

  • 1 Room:
    • Bad Gas
    • Bombs are Key
    • Feels like I'm walking on sunshine!
    • Friends Till The End!
    • Horf!
    • I Found Pills
    • Puberty
    • Something's Wrong...
    • Telepills
    • X-Lax
  • 2 Rooms:
    • Bad Trip
    • Infested?
    • Infested!
    • Percs!
    • Pheromones
    • Re-Lax
  • 3 Rooms:
    • Experimental Pill
    • Explosive Diarrhea
    • I'm Drowsy...
    • Lemon Party
    • Power Pill!
  • 4 Rooms:
    • Gulp!
    • I can see forever!
    • Stat-downs (health, range, speed, tears, luck, shot speed)
  • 6 Rooms:
    •  ???
    • Addicted!
    • Amnesia
    • Hematemesis
    • I'm Excited!!!
    • One makes you larger
    • One makes you small
    • Paralysis
    • Pretty Fly
    • R U A Wizard?
    • Retro Vision
    • Vurp!
    • Stat-ups (range, speed, tears, luck, shot speed)
  • 12 Rooms:
    • 48 Hour Energy
    • Balls of Steel
    • Full Health
    • Health Up

Golden Pills use the recharge time of the pill they mimicked. Recharge time is unaffected by whether or not it was a normal pill or Horse Pill.

Note that because the recharge time is determined after using the pill, Placebo cannot be used as a way to narrow down what type of pill Isaac is holding before he uses it.


  • Removed in Repentance 48 Hour Energy: Can spawn an unlimited number of Lil' Batteries, allowing unlimited use of another activated item or pill.
  • Removed in Repentance Balls of Steel + Sharp Plug Sharp Plug: The player can gain functional invincibility.
    • Removed in Repentance The Wafer The Wafer: Allows for Virtually infinite health.
  • Added in RepentanceBook of Virtues Book of Virtues: Spawns white wisps on the middle ring. The wisps spawn Pills when destroyed. The effects of the wisps and types of pills they spawn is independent from Placebo's charge time and the most recently used pill. Unlike Blank Card Blank Card and Clear Rune Clear Rune, enemies killed by these wisps' tears do not have a chance to drop pills.
  • Added in RepentanceButter! Butter!: Because Placebo is dropped upon usage, the recharge time is reset to 4, allowing to use more expensive pills much more frequently.
  • Added in Repentance Vurp: Allows pills that normally take 12 rooms for Placebo to charge to be used twice as frequently.


  • Starter Deck Starter Deck: All pills are replaced by cards, rendering Placebo useless.
  • If used with Bethany Bethany or Tainted Bethany Tainted Bethany, using a pill that has a larger charge requirement than Placebo's current will still consume soul or blood charges equal to the difference (likely a bug).

In-game Footage[]


  • Placebo is a medicine or procedure prescribed for the psychological benefit to the patient rather than for any physiological effect.


Bug Bug! Strange behavior when the player has a 12-charge pill, Placebo is dropped on the ground with more than 4 charges and the player has Battery - when the player re-equips Placebo, it's capped at 8 charges, which stack strangely in the UI