Binding of Isaac: Rebirth Wiki
Suicide   King
Character Lazarus appearance.png
Full red heartFull red heartFull red heart
Table dividing line 1.png
Challenge Number
Starting Items
Ipecac Ipecac
Mr. Mega Mr. Mega
My Reflection My Reflection
1 random pill
Available Rooms
Item Pool Treasure Room.png: no          Item Pool Shop.png: yes
Boss Isaac portrait.png
Suicide King Suicide King
Unlock Method

Suicide King Defeat Mom's Heart 11 times

Suicide King is Challenge #7. Lazarus Lazarus is the default character for this challenge, and he starts with Ipecac Ipecac, Mr. Mega Mr. Mega and My Reflection My Reflection, as well as a random pill. The goal is to defeat Isaac Isaac. This Challenge is unlocked alongside It Lives It Lives.


  • Though Ipecac and Mr. Mega would be a powerful build in a normal run, My Reflection causes tears to loop back around towards Lazarus Lazarus, forcing him to have to avoid not only enemy tears but his own as well. This also makes aiming tears significantly harder.


  • The 1 pip and 6 pip dice rooms will not reroll the starting items for this challenge but will reroll any others.
  • Lazarus has one extra life by default, granting him some survivability.
    • Added in Repentance Lazarus Risen Lazarus Risen now regains his extra life and reverts back to Lazarus Lazarus upon entering a new floor, thus allowing for more survivability.
  • Due to My Reflection, the range is diminished. With a little practice, however, it can be easy to tell how far away the shot will travel. Lining up enemies with that distance will make it easier to score direct hits that won't come back. One way to track this is by the shadow of the Ipecac tear.
  • Ipecac's explosive tears can be used to break rocks, mushrooms, and skulls, and open secret rooms.
  • Crawl Space Crawl Spaces are very valuable due to the lack of Treasure Room Treasure Rooms, making the destruction of all encountered rocks a viable strategy. Most items that can be acquired this way are useful, but Pyromaniac Pyromaniac and Added in AfterbirthHost Hat Host Hat are especially noteworthy for their ability to prevent all self-damage inflicted on Lazarus.
  • While Dr. Fetus Dr. Fetus will not prevent any damage inflicted by bombs, it will massively increase Lazarus's damage.
  • Familiars such as Cube of Meat Cube of Meat, Ball of Bandages Ball of Bandages, or any friendly fly orbital can help protect Lazarus.
    • If properly aiming the Ipecac shots while simultaneously dodging them proves too challenging, some familiars or orbitals can serve as a consistent means of dealing damage without firing tears.
  • Grouping enemies together is an effective way of clearing rooms while minimizing the amount of tears needing to be fired per room.
  • Because Ipecac also increases the damage of Blue Flies and Blue Spiders, obtaining an item that spawns them can be extremely useful.
  • It is possible to hit enemies without having to worry about My Reflection by moving in tandem with the Ipecac tear, making the shot faster. This method only works with a high Speed stat.
  • A higher Shot Speed stat allows the tears to fly further away from Lazarus before returning, allowing enemies to be shot from further away while reducing the risk of being caught in the blast radius.
  • A lower Range stat is advantageous. It shortens the way back to Lazarus whereas a high Range stat seems to home him.
  • The Magic Fingers Magic Fingers item is a common shop item that is affected by Ipecac's damage increase. This makes it extremely viable as an alternative damage source to Ipecac tears, especially in runs with a large coin count.
  • If Envy Envy is encountered, and it drops Shoop Da Whoop! Shoop Da Whoop!, it is highly advised to pick it up. Due to the item's relatively quick recharge time, and the fact that its damage is greatly increased by Ipecac, it can be used as an ace in the hole to clear challenging rooms and easily defeat bosses.
  • Mom's Knife Mom's Knife can be purchased from a Devil Room Devil Room if found with a Red Chest or using Goat Head Goat Head, overriding Ipecac and making the challenge much easier.
  • Death's Touch Death's Touch allows the tears to do damage in-flight, making it significantly easier to hit enemies.
  • Technology Technology is an immensely useful item that can be acquired from Boss Rush Boss Rush, as it overrides Ipecac, granting infinite range and no explosive damage.
  • Gnawed Leaf Gnawed Leaf is another useful item from Crawl Space Crawl Spaces, allowing Lazarus to turn into a statue just before the Ipecac tears hit him. This is only really useful for destroying objects.
  • Added in AfterbirthSuccubus Succubus is an incredibly useful familiar, as its damage scales with Lazarus'. Succubus allows the challenge to be cleared without using tears as it only takes a few seconds for it to clear out a regular-sized room autonomously.
  • Added in Afterbirth Familiars that mimic Lazarus' tears, such as Added in AfterbirthFate's Reward Fate's Reward, are not recommended for this challenge. While they do increase Lazarus' overall damage output, they are very difficult to avoid, as they are usually fired directly towards Lazarus.
  • Added in RepentanceSpirit Sword Spirit Sword overrides the explosive projectiles from Ipecac if Lazarus is not at full health, making self-damage far less likely at the cost of making Lazarus into a close-range fighter.
  • Added in RepentanceBrimstone Brimstone and Added in RepentanceSulfur Sulfur are extremely useful for clearing rooms and has an absurd synergy with worm trinkets.
  • Added in RepentanceSharp Key Sharp Key can fire a damage-boosted Ipecac shot with great accuracy, and with enough keys, can be rapidly used for mass damage.
  • Added in RepentanceBrain Worm Brain Worm, Hook Worm Hook Worm and Whip Worm Whip Worm are useful trinkets and should be collected if possible.
    • Brain Worm forces some tears to snap 90 degrees to target enemies that they may have missed.
    • Hook Worm allows tears to hit enemies more easily, while also making them easier to avoid by Lazarus.
    • Whip Worm forces tears to fly very fast and low, usually preventing enemies from dodging them. It also makes tears that hit the edge of the screen explode rather than coming back to Lazarus.
    • Ring Worm Ring Worm is a somewhat less useful alternative.

Unlockable Achievements[]


  • The Devil Room Devil Room at the end of the It Lives It Lives boss fight will contain regular Deals with the Devil instead of a trap door, as the challenge requires Lazarus to go to the Cathedral Cathedral.
  • If the player somehow manages to end up going to Sheol Sheol instead of Cathedral Cathedral (i.e. through a trapdoor in Womb Womb II), defeating Satan Satan will successfully finish the challenge and erroneously unlock the achievement.


Bug Bug! XboxOne If the game crashes during the challenge and is reloaded, Lazarus will lose Ipecac and have his normal tears.