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then just play the run looking for the blue pills and/or a placebo.
optionally - you can do this in greed mode, since there can be pill slots in the shop. i did this achievement 2 times in greed like this, got it on 2nd attempt each time. just go on a spending spree if you see pill slot and if you have extra money. don't forget that you still need to fight enemies, but also you don't have to win this run, you're going for the achievement in the first place. again, placebo is a must have here.
oh, if you find D20 or DInf - break the game to guarantee this achievement at some point
if you want to do this in an unfair way, then just enable console and give yourself pills with a command. i think the command should be
g p43
which means giveitem p (pill) 43 (ID of gulp)
best of luck!
In-game secret number 321 (beat the Lamb, start a victory lap, kill the Lamb again, start the next lap).
If you do the unlock now, while you're at it, keep doing VLs in a row (always go to the Lamb and accept to start the next one). There are a few unlocks to get that way, the last one is called Rerun.
https://bindingofisaacrebirth.fandom.com/wiki/Debug_Console
Though the third is just the "Rerun" function.
i just finished up betting the two item unlocks. i skipped rerun, because it's not a feature i care for, and i don't care about cheevos, just content XD
so that's over with for my purposes.
thanks again to both the OP (for starting the thread) and the others for pointing out the things to know
1) to be able to get achievements with console, just like with mods, you need to kill mom at least once on a file
2) go to C:\Users\[username]\Documents\My Games\Binding of Isaac Repentance, find options.ini file and in it change EnableDebugConsole to =1. Then in game when you press ~ you will open the console.
If you're interested more in this topic, the tboi wiki has a page for debug console with all the commands and stuff