Lil Spewer is an unlockable familiar in The Binding of Isaac, added in the Afterbirth+ DLC.

Spawns a random pill.

Spawns a familiar that follows Isaac. It charges up for 1 second and fires different types of creep based on his appearance that changes when Isaac uses a pill.

Possible creep types:

• Green: deals 0.35 damage per tick (10.5 per second) - total 35.

• Red: deals 12 damage per tick (120 per second) - total 24.

• Yellow: 2 damage per tick at its lowest range, up to 15.2 damage at its furthest range (~6.47 damage per second, based on range). Damage ticks for a total of 9 times.

• Black/White: slows enemies down.

The familiar always starts with green creep.

Has a 1% chance of being dropped upon defeating Blastocyst.

This page shows the latest information as of the new Repentance+ (Online Co-op) DLC.
To see information about this item for the previous Repentance version, check this page instead.

Have Isaac die to his own explosion from Ipecac, Bob's Rotten Head or a Horf! pill.

Lil Spewer can be found in the following item pools:

The following tags are applied to this item:

The following special synergies and interactions for Lil Spewer have been documented.

* Note that not all possible synergies and interactions are listed here.

Below is the Internal Item Description as shown in-game.
Note that some stat changes are not displayed here. Please see the main description for the full effects.

Lil Spewer

• Following familiar that charges and releases puke attacks that create creep with different effects
• The familiar's form and creep attack change each time Isaac consumes a pill
• Spawns 1 random pill when picked up
• Abyss: x1 locust .75x Isaac's damage

• Check out the item description on the external Isaac Wiki.