Item: Lil Monstro

Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.

Grants an empty heart container. Increases damage, range and shot height while reducing speed.

Gives a random chance for projectiles to fire in all 4 cardinal directions.

1-3 Blue flies randomly spawn every time Isaac gets hit.

Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.

Grants flight and one heart container.

Speed down; gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.

Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.

Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.

Increases Damage by 1.

Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.

Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.

Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.

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

Increases speed by 0.3.

Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.

Grants a chance of converting any red hearts pickups into soul hearts instead.

Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.

Allows Isaac to carry two cards or pills (or a combination of both) at the same time.

+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.