Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard?pill. Isaac's tears also travel above all obstacles.
Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.
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.
Spawns a familiar that flies the room while firing, dealing double Isaac's tear damage to enemies that come in contact and retrieving pickups.
Bucket of Lard
Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.
Increases damage by 1, range by 5.25, and tear height by 0.5.
Spawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.
Grants two soul hearts. Isaac now repels enemy projectiles.
Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.
Adds one filled heart container and increases Shot Speed.
Spawns an egg familiar, which cracks and turns into a random charmed enemy when Isaac is hurt. The egg regenerates upon entering a different room.
Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.
Spawns a beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, dealing contact damage.
Displays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.
+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.
There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.