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The achievement tells you to use 5 Gulp! pills through finding and using 5 of them in the same run, or using the Placebo item 5 times while holding one. The achievement doesn't require trinkets to be consumed.
The achievement will only count if you use the pill 5 times in a single run, the number of pills used doesn't carry over in separate runs.
1. Play as Lazarus on a normal run and reset until you get a gulp! pill. Save all your bombs for destroying mushrooms in clusters in the caves and save all your money to buy pill and pill items in the shop. Also remember to clear every single room and use sacrifice rooms to maximize the chances of finding the pills. This isn't the best way to do it, but it's pretty fun to setup a run like this imo.
2. Play greed mode as Lazarus and restart until you get a gulp! pill. Remember what color it is, just in case it shows up in the shop. If you can find a means of breaking the game, do it and then proceed to buy pills infinitely until the achievement pops up. This is probably the more favored way, but there's a lot of RNG involved.