Item: Monstro's Lung
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.
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.
Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Increases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.
Pull a chain and ball behind you that will damage enemies on contact and is able to break stones.
Blood of the Martyr
Increases Damage by 1, and turns Isaac's tears into blood tears.
Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Familiar that follows Isaac, leaving blood creep on the ground.
The Small Rock
Increases damage by 1, increases tears by 0.2, and decreases speed by 0.1.
Follows Isaac around shooting normal tears.
+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)
Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.
Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.
An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Key Piece 2
Combined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
If the character has half a red heart or no red hearts after taking damage, it triggers the Book Of Shadows effect, creating a shield that nullifies all types of damage for 5 seconds. Also allows entrance into The Chest.
A Familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.