Item: The Book of Sin
Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies.
When used, the Mega Bean will freeze all enemies in the current room for a couple of seconds, deal 5 damage and poison any enemies near Isaac, and send a wave of spikes that deals 10 damage across the room in the direction Isaac is facing.
Spawns 2-4 blue flies to damage enemies.
Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.
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.
Glowing Hour Glass
When used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state.
Creates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius.
Spawns a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in The Dark Room.
Book of the Dead
Upon use, spawns a charmed Bony or an orbital bone for each enemy killed in the current room.
Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears.
Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.
Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.
Spawns a stationary fly familiar that fires tears at nearby enemies.
Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.
Summons a random familiar for the current room. Can summon familiars not yet unlocked.
Mom's Bottle of Pills
Gives Isaac a random pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.
Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.
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.
Forget Me Now
When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.