Item: Pageant Boy
Spawns a random pill, and grants a small Spewer familiar that charges up and fires different types of creep.
Increases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.
A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.
Sets the amount of red heart containers to 1, but gives Isaac 9 extra lives. After dying, Isaac is teleported to the last safe room. New heart containers can be obtained after picking up this item, but after each death, the number of heart containers is set to 1 again.
The Small Rock
Increases damage by 1, increases tears by 0.2, and decreases speed by 0.1.
Spawns a familiar that follows Isaac around and fires homing tears.
A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.
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.
Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.
Grants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.
A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
Grants 7 bombs and allows bombs to be placed rapidly.
Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
Tears have a chance to charm enemies.
Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Grants two soul hearts. Isaac now repels enemy projectiles.
Increases damage, but also increases the chance of champion enemies appearing.
Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.