Item: The Pact

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

Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.

Adds 3 black hearts and increases Damage by 1.

Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.

A familiar that follows Isaac around shooting blood tears.

Gives Isaac a random tear effect every room.
Removed in Afterbirth: The effect given changes upon entering a room.
Added in Afterbirth: The effect changes every 3 seconds.

Enemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.

Isaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.

Spawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.

Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.

All stats up.

Reveals all rooms for every floor. However, it does not reveal icons or secret rooms.

Dagger orbits Isaac, dealing very high damage.

Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.

A white orbiting fly which deals 3 contact damage per tick to enemies. This familiar orbits Isaac at a middle length distance somewhere between Distant Admiration and Forever Alone.

When hit, spawns up to 2 blue spiders.

Orbiting familiar that deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Cube of Meat.

A familiar that charges forward and deals touch damage to any enemies in its path.

Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.

Grants one Heart Container and gives 2 Soul Hearts.