Grants a random item effect for the current room.
Summons a random familiar for the current room. Can summon familiars not yet unlocked.
Upon use, deals one heart of damage to Isaac and grants +1.2 damage for the current room.
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.
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.
When used, converts two soul hearts into a heart container.
Bombs you place explode only when you use this item. Gives 5 bombs.
Upon use, makes a random item from a shop, devil deal, or black market free.
Isaac releases bad gas, poisoning any enemy in close vicinity.
Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.
Glowing Hour Glass
When used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state.
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.
Damages all enemies in the room and slows them and their projectiles down.
Throwing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be charmed until it dies, persisting between floors.
How to Jump
Gives Isaac the ability to jump (over gaps, spikes, etc.).
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.
Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.
Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.
Book of Revelations
Adds 1 soul heart, increases the chance for a Devilor Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).