Isaac can hold 2 pills at once and all cards are replaced by pills.
Spawns 2 keys. Generates additional pickups from chests.
Spawns an orbiting eye familiar that fires tears every 2 seconds.
Grants Isaac one red heart container and fully restores Isaac's health.
Increases speed and reduces character size. Also gives a random pill.
Dagger orbits Isaac, dealing very high damage.
When hit, summons a white attack fly similar to Distant Admiration for the current room.
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.
Grants a heart container for every 25 coins Isaac has.
Key Piece 1
Combined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
Grants an active item charge every 15 enemies killed.
A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
All standard bomb pickups become 1+1 bomb pickups.