Item: There's Options

Grants flight and increases speed.

Grants quadruple shot but decreases tears.

Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.

Drops a random trinket. Grants a second trinket slot.

A familiar that spawns blue flies.

Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.

+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.

Isaac's tears split in two when they hit something.

Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.

Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.

Adds a chance to fire a booger which sticks to enemies and poisons them.

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

One of two parts necessary to create Mom's Shovel.

Inflicts poison to enemies who make contact with Isaac. Speed down.

Isaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.

Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.

Isaac gains a shield that protects him from enemy shots.

Spawns a familiar that follows Isaac around and collects red hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one soul heart, one hostile Spider or one friendly blue spider.

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.

Upon picking up a certain amount of health, spawn a permanent angelic familiar.