Activated Collectible Items
Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies while also casting the effect of Crack the Sky.
We Need to Go Deeper!
Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.
Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.
Teleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.
Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.
The Pinking Shears
Separates Isaac's head and body for the current room. Isaac's head, which now has flight, will be under the player's control, while his body will seek out enemies to attack by contact damage.
Damages all enemies in the room significantly.
Adds one soul heart and allows the breaking of rocksand damaging enemies by simply walking over them. Increases damage and decreases speed. All effects except for the Soul Heart wear off upon leaving the room.
When at full health, up to 4 extra hearts can be stored in the jar.
Upon activation, enemies and their projectiles are slowed down for a short duration.
Upon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.
Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.
Throws out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.
Throws a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups.
The Book of Sin
Spawns a random pickup, pill, card, or trinket.
The Book of Belial
Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
Upon activation, Isaac gains flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan.
Isaac releases bad gas, poisoning any enemy in close vicinity.
Teleports you to a random room on the level.
Telepathy for Dummies
Upon activation, grants homing tears for the current room.
Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears.
Damages all enemies in the room and slows them and their projectiles down.
Shoop Da Whoop!
Fires a laser from Isaac's mouth.
Upon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.
Upon activation, Isaac gains a black heart.
Bombs you place explode only when you use this item. Gives 5 bombs.
Throws a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots.
Upon use, deals one heart of damage to Isaac and grants +1.2 damage for the current room.
Upon activation, 1 coin will be consumed, and a random pickup may drop, similar to the slot machine.
Upon use, spawns certain pickups or itemsdepending on the floor it is used on. Single-use.
Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.
My Little Unicorn
Upon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.
Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.
Summons a random familiar for the current room. Can summon familiars not yet unlocked.
Upon use, inflicts fear to all enemies in the room for 5 seconds.
Upon use, petrifies all enemies in the current room for approximately 4 seconds.
Mom's Bottle of Pills
Gives Isaac a random pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.
For 1 coin, damages all enemies in the room.
Creates a small yellow pool of creep, which damages enemies that cross it.
Creates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius.
Upon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the blood donation machine.
Shoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.
How to Jump
Gives Isaac the ability to jump (over gaps, spikes, etc.).
Head of Krampus
Fires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot.
Removes one red heart container in exchange for gaining 3 Soul Hearts.
Spawns 2-4 blue flies to damage enemies.