Spawns a Mysterious Paper, increases tears, and grants a bone heart.
+0.3 tears up. Allows Isaac to fire tears diagonally.
Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
Spawns a white poop familiar, which turns into a white poop when Isaac is hurt.
Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Zodiac will give Isaac a random zodiac item effect that changes after every floor.
Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.
Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.
Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black Charger familiar that will attack enemies. The Charger will be killed if it is damaged too much.
The Ludovico Technique
Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
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.
Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Gives a random chance for projectiles to fire in all 4 cardinal directions.
Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.
Adds one heart container and drops a random trinket.
Increases damage, and adds 1 heart container.
After every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Mom's Coin Purse
Spawns 4 random pills around Isaac.
Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.