Item: Butt Bombs
Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.
Grants one red heart container, restores 5 red hearts, and increases speed by 0.3.
Spear of Destiny
In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.
After taking damage a certain amount of times, a permanent demonic familiar spawns.
An orbital angel which does 7 contact damage per tick and blocks enemy shots. Upon blocking 10 shots in a room it drops an eternal heart.
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.
Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.
Adds a chance to fire a gas cloud that damages nearby enemies.
Causes Isaac's activated item to activate twice on each use.
Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.
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.
Zodiac will give Isaac a random zodiac item effect that changes after every floor.
Gives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.
Pay to Play
This item turns all doors that require a key into doors which need a coin to enter instead. This affects shops, item rooms, libraries and other key doors.
Increases tears by 0.4, and spawns 2 Soul Hearts pickups.
Spawns 3 random trinkets. Taking damage has a small chance to swallow Isaac's currently held trinket, gaining its effect permanently.
Increases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.