Item: Ghost Pepper

Doubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.

A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.

When hit, summons a white attack fly similar to Distant Admiration for the current room.

Spawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.

+5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects troll bombs.

Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.

Gives Isaac a random tear effect every room.
Removed in Afterbirth: The effect given changes upon entering a room.
Added in Afterbirth: The effect changes every 3 seconds.

Increases Damage by 1.

Isaac's tears split in two when they hit something.

Allows Isaac to hold two active items.

After Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.

Increases Tears by 0.7.

Reveals all special rooms (except secret rooms of any kind).

Tears bounce off walls, enemies, and environmental objects.

+1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.

Increases damage based on how many empty heart containers Isaac has.

Spawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.

Grants spectral tears and flight.

Spawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.

Grants 10 bombs.