Upon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.
Grants Isaac one full red heart container.
Increases Damage by 1 and adds a chance to shoot fear tears.
Spawns a familiar that flies the room while firing, dealing double Isaac's tear damage to enemies that come in contact and retrieving pickups.
Grants a reward if all enemies in a room are killed in the order they are marked.
After taking damage a certain amount of times, a permanent demonic familiar spawns.
Spawns a familiar that follows Isaac around and fires spectral tears.
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.
+0.7 tears up. Grants a random item at the start of the next run.
Spawns a familiar that follows Isaac around and fires homing tears.
Sets your key count to the maximum of 99.
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.
Isaac emits a beam from his face. Isaac's tears travel in the path of the beam.
Head of the Keeper
Isaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.
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.
Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.
After Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.
Inflicts poison to enemies who make contact with Isaac. Speed down.