Item: Guppy's Collar
Adds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
A familiar that follows Isaac around shooting blood tears.
Increases chance of finding gold chests and normal chests, but reduces chance of finding pickups.
Adds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.
Tears have a chance to charm enemies.
Sack of Pennies
Isaac is followed by a small bag that drops a coin every 2 rooms.
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.
Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.
Enemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.
Increases damage and increases the chance for a Devil or Angel Room to appear.
An angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.
A bag that follows Isaac and drops a random rune every 3 rooms.
Grants one red heart container, restores 5 red hearts, and increases speed by 0.3.
Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.
Increases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.
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.
Chance to block projectiles coming from any direction.
???'s Only Friend
Summons a big attack fly that can be controlled with the shooting direction-keys.