Item: Bursting Sack
+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)
Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.
Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.
Adds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.
Isaac's tears have a chance to stick to enemies and explode.
Increases damage as Isaac receives damage. Damage increase stays for the whole floor.
Guppy's Hair Ball
Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.
Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
Isaac can hold 2 cards at once and all pills are replaced by cards.
Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
Spawns a bone familiar that can be aimed with the fire buttons and does contact damage.
Doubles damage, halves tears stat, and greatly reduces shot speed.
Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies.
Increases tears by 0.4, and spawns 2 Soul Hearts pickups.
+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.
Increases speed and reduces character size. Also gives a random pill.
An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Reveals all special rooms (except secret rooms of any kind).