Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
A familiar that mirrors the player's movements and shoots in the opposite direction.
Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
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.
Adds 3 black hearts and increases Damage by 1.
Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
Blood of the Martyr
Increases Damage by 1, and turns Isaac's tears into blood tears.
A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
Isaac can hold 2 pills at once and all cards are replaced by pills.
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.
When Isaac receives damage, the bottle breaks and a puddle of blue creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.
Drops a random card or rune. Doubles the effects of cards and runes.
Spawns a familiar that follows Isaac around and fires homing tears.
Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.
Grants a full heart container, and a chance to regenerate a half-heart of health every minute of gameplay.
When Isaac is hit, 1 point of an item's charge is filled.