Item: Lil Spewer
Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.
Cube of Meat
Orbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.
Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.
Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
Increases the size of blue spiders and Blue Flies and doubles the amount of damage they deal.
Randomizes all passive items upon pickup and at the start of each succeeding floor.
Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.
Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.
Reveals type of adjacent rooms, including location for secret rooms and super secret rooms.
-1 Tear Delay, adds knock-back shots and increases tear size.
Grants Isaac a permanent 50% chance to respawn with 1/2 of a red heart after death.
Grants Isaac one full red heart container.
Randomly increases and decreases some of the character's stats. There will always be at least one stat increase and one decrease and the same stats can be increased/decreased multiple times.
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.
Sack of Sacks
Spawns a sack familiar that has a chance to drop a sack upon clearing a room.
A glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the rest of the room.
Spawns a familiar that slowly charges forward and damages enemies in its path.
Displays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.