Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.
Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.
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Gives 1 black heart. Upon taking damage that reduces Isaac's health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.
Grants an active item charge every 15 enemies killed.
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.
Grants Isaac a permanent 50% chance to respawn with 1/2 of a red heart after death.
An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Grants a heart container for every 25 coins Isaac has.
+1.7 tears, +0.3 speed, reduces damage.
Adds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.
Increases damage by 1, range by 5.25, and tear height by 0.5.
Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.
Isaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.
Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
Spawns a fly familiar that orbits around a random enemy and deals 5 damage per tick to enemies it comes in contact with.
Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.
Spawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies, and increases the speed of all orbital familiars.