Throws out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.
Dead Sea Scrolls
Triggers the effect of a random activated item from a list of possible options (not every activated item is included).
The Book of Belial
Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead.
Crack the Sky
Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.
Throws a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots.
Forget Me Now
When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.
Telepathy for Dummies
Upon activation, grants homing tears for the current room.
Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.
Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor's secret and super secret rooms.
Upon use, makes a random item from a shop, devil deal, or black market free.
When used, has a 50% chance to drop one random type of coin (penny, nickel, or dime).
Summons a controllable ghost that can perform various tasks depending on what it targets.
Upon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.
Upon use, sacrifices up to 2 familiars and spawns an item from the Devil Room Pool for each familiar sacrificed.
We Need to Go Deeper!
Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.
When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.
Sets a big red target on the ground (similar to the Epic Fetus item) which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius.