Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
Grants four soul hearts and fully restores Isaac's red health.
Increases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.
Has a chance to drop a random pickup when Isaac takes damage.
Spawns a finger familiar that points at enemies, dealing constant damage.
Increases speed by 0.3 and shot speed by 20%.
All types of fly except Boom Fly and Red Boom Fly become passive and slowly move towards Isaac. Does not prevent contact damage.
Increases speed and reduces character size. Also gives a random pill.
+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.
Increases chance of finding gold chests and normal chests, but reduces chance of finding pickups.
Increases damage based on how many empty heart containers Isaac has.
Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.
Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Reveals and opens all Secret Room and Super Secret Room entrances.
Spear of Destiny
In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.
Gives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.
Drops a random trinket. Grants a second trinket slot.