- is gold efficient without the active and passive effects.
- can become gold efficient if the passive grants a minimum of (This can be achieved if target current health is 575 or higher).
- Champions who are highly dependent on basic attacks (
, , , , , etc.) often build this item due to the attack speed, lifesteal, and the passive that helps boost their autoattacks. Champions with an attack speed steroid like , , , or champions with on-hit effects skills like , , , can synergize well with , making better use of the passive.
- Champions that autoattack and deal true damage also benefit from the passive on , as the best counter to true damage is to build health, however, being able to constantly autoattack is still the foremost criteria. Prime examples are , or .
- AD Casters can also consider picking this item up as a side item for extra damage and sustain vs HP targets, but only if they have abilities that directly synergize with auto attacks via applying on-hit effects (e.g. , and ).
- skillshots, or most importantly, improve kiting. can be seen as a soft defensive item, as its active offers high utility. Depending on the situation, it can be used to migitate burst, lock down a target, evade
- This item is often built as a form of "anti-tank" item used to counter health-stacking champions (or champions that scale well in health) such as , , , , and .
- and are strong counters to , as both provide armor and an attack speed slow; in the former's case, it also provides health and the two actives mostly mitigate each other. The latter's case has more armor and also has its attack speed slow in the form of an aura.
- The passive damage is not factored into critical strikes, as it is an on-hit effect.
- The passive damage does, however, apply life steal.
- The active's heal is based on the damage dealt after reductions, and so will be mitigated by armor and other forms of damage reduction.
- Although and both have a in their recipe, their item actives are considered distinct from one another and will not put each other on cooldown.
- No actual movement speed is stolen. The active simultaneously slows the target by 25% and applies a 25% movement speed buff to the user that stacks additively with other percentage movement speed buffs.
- Shadow Isles after 'grief overcame his reason' and failed to resurrect his wife. is named after uncle, king of an unnamed realm who transformed the Blessed Isles into the undead-dwelling
- With the start of the preseason of Season 3 was removed and was replaced by .