Converts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
Tears bounce off walls, enemies, and environmental objects.
Adds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.
Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
A familiar that follows Isaac around shooting blood tears.
Tears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
Grants 7 bombs and allows bombs to be placed rapidly.
Cube of Meat
Orbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.
Replaces tears with a piercing laser with unlimited range.
After taking damage a certain amount of times, a permanent demonic familiar spawns.
Speed down; gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.
Crown of Light
Gives Isaac a crown that glows blue when active, and turns gray when inactive. While Isaac has no empty red heart containers, Isaac's tears are replaced with blue diamond tears that deal double damage. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.
Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.
A familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact with in each room. If any enemies walk into its path, it will deal 7 contact damage per tick. If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously travelling until it meets another wall or obstacle.
Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Gives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.
Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.