Item: Sister Maggy

Increases range, tears, and shot speed when at exactly one red heart.

Tears fired from left eye do increased damage.

Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.

Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills".

Increases Speed and Shot Height and decreases Isaac's size, but lowers Range.

There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.

Grants four soul hearts and fully restores Isaac's red health.

Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.

Increases Damage by 1.

Increases Damage by 1 and adds a chance to shoot fear tears.

Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.

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.

Isaac gains a shield that protects him from enemy shots.

Daddy Long Legs' shadow follows Isaac and stomps on enemies.

A familiar that drops a Little Battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.

Doubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.

Adds 1 heart container.

This item will boost one of Isaac's stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.

Spawns a familiar that follows Isaac around and fires homing tears.

+1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.