Item: Tech X
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.
Spawns a familiar that flies the room while firing, dealing double Isaac's tear damage to enemies that come in contact and retrieving pickups.
Spawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.
Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
Spawns a familiar that follows Isaac around and fires homing tears.
Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
Gives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.
+0.7 tears up. Grants a random item at the start of the next run.
The Ludovico Technique
Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.
Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Increases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.
Sack of Pennies
Isaac is followed by a small bag that drops a coin every 2 rooms.
+1.7 tears, +0.3 speed, reduces damage.
Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.