Collection Page (Afterbirth †)

Collection Page
Rebirth	Afterbirth	Afterbirth †

The table below is a recreation of what each page looks like when Afterbirth † is installed and all 547 items have been obtained.

Pages

(Click images to open the corresponding item page)

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The Sad Onion Increases Tears by 0.7.	The Inner Eye Grants triple shot but decreases tears.	Spoon Bender Grants Isaac homing tears.	Cricket's Head Increases damage by 0.5, and multiplies it by 1.5x.	My Reflection Gives Isaac's tears a boomerang effect, and increases range and shot speed.	Number One +1.5 tears, -17.62 range	Blood of the Martyr Increases Damage by 1, and turns Isaac's tears into blood tears.	Brother Bobby Follows Isaac around shooting normal tears.	Skatole All types of fly except Boom Fly and Red Boom Fly become passive and slowly move towards Isaac. Does not prevent contact damage.	Halo of Flies Spawns two pretty fly familiars that block enemy shots and deal contact damage to enemies.	1up! Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.	Magic Mushroom Increases all stats and enlargens Isaac.	The Virus Inflicts poison to enemies who make contact with Isaac. Speed down.	Roid Rage Increases speed by 0.6, range by 5.25, and tear height by 0.5.	<3 Grants Isaac one red heart container and fully restores Isaac's health.	Raw Liver Grants 2 Heart Containers and completely restores health.	Skeleton Key Sets your key count to the maximum of 99.	A Dollar Gives Isaac 99 coins. Can be found multiple times in a single playthrough.	Boom! Grants 10 bombs.	Transcendence Grants flight.
The Compass Reveals all special rooms (except secret rooms of any kind).	Lunch Adds 1 heart container.	Dinner Adds 1 heart container.	Dessert Grants Isaac one full red heart container.	Breakfast Grants Isaac one full red heart container.	Rotten Meat Adds one heart container.	Wooden Spoon Increases speed by 0.3.	The Belt Increases speed by 0.3.	Mom's Underwear Increases range.	Mom's Heels Increases range.	Mom's Lipstick Increases range and shot height.	Wire Coat Hanger Increases Tears by 0.7.	The Bible Upon activation, Isaac gains flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan.	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. Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it, or increases the chance by 12.5%.	The Necronomicon Damages all enemies in the room significantly.	The Poop Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.	Mr. Boom Drops a large bomb.	Tammy's Head Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears.	Mom's Bra Upon use, petrifies all enemies in the current room for approximately 4 seconds.	Kamikaze! 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.
Mom's Pad Upon use, inflicts fear to all enemies in the room for 5 seconds.	Bob's Rotten Head Upon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.	Teleport Teleports you to a random room on the level.	Yum Heart Restores 1 whole red heart.	Lucky Foot +1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)	Doctor's Remote 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.	Cupid's Arrow Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.	Shoop Da Whoop! Fires a laser from Isaac's mouth.	Steven Increases Damage by 1.	Pentagram Increases damage and increases the chance for a Devil or Angel Room to appear.	Dr. Fetus Tears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.	Magneto Pulls pickups towards Isaac.	Treasure Map Reveals all rooms for every floor. However, it does not reveal icons or secret rooms.	Mom's Eye Allows Isaac to fire tears from the back of his head.	Lemon Mishap Creates a small yellow pool of creep, which damages enemies that cross it.	Distant Admiration A red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.	Book of Shadows Upon use, creates a protective shield nullifying all types of damage for 10 seconds.	The Ladder Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.	Charm of the Vampire Heals the character for half of a red heart for every 13 monsters killed.	The Battery Activated Items can be "overcharged" to allow for an additional use.
Steam Sale Reduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.	Anarchist Cookbook Spawns six troll bombs around the room.	The Hourglass Upon activation, enemies and their projectiles are slowed down for a short duration.	Sister Maggy A familiar that follows Isaac around shooting blood tears.	Technology Replaces tears with a piercing laser with unlimited range.	Chocolate Milk Grants charged tears that deal greater damage when fully charged.	Growth Hormones Increases damage by 1 and speed by 0.4.	Mini Mush Increases Speed and Shot Height and decreases Isaac's size, but lowers Range.	Rosary Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.	Cube of Meat Orbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.	A Quarter Adds 25 to Isaac's coin count, capping at 99.	PHD Converts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.	X-Ray Vision Reveals and opens all Secret Room and Super Secret Room entrances.	My Little Unicorn Upon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.	Book of Revelations Adds 1 soul heart, increases the chance for a Devil or Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).	The Mark Increases Damage and Speed, plus adds one Soul Heart.	The Pact Increases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.	Dead Cat Sets the amount of red heart containers to 1, but gives Isaac 9 extra lives. After dying, Isaac is teleported to the last safe room. New heart containers can be obtained after picking up this item, but after each death, the number of heart containers is set to 1 again.	Lord of the Pit Grants flight and increases speed.	The Nail Adds one soul heart and allows the breaking of rocks and damaging enemies by simply walking over them. Increases damage and decreases speed. All effects except for the Soul Heart wear off upon leaving the room.
We Need to Go Deeper! Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.	Deck of Cards Gives Isaac a random Tarot Card.	Monstro's Tooth Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.	Loki's Horns Gives a random chance for projectiles to fire in all 4 cardinal directions.	Little Chubby A familiar that charges forward and deals touch damage to any enemies in its path.	Spider Bite Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.	The Small Rock Increases damage by 1, increases tears by 0.2, and decreases speed by 0.1.	Spelunker Hat Reveals type of adjacent rooms, including location for secret rooms and super secret rooms.	Super Bandage Grants one Heart Container and gives 2 Soul Hearts.	The Gamekid Upon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.	Sack of Pennies Isaac is followed by a small bag that drops a coin every 2 rooms.	Robo-Baby Follows Isaac around, shooting enemies with an eye laser similar to Technology.	Little C.H.A.D. A familiar who will drop a half red heart every 2 rooms.	The Book of Sin Spawns a random pickup, pill, card, or trinket.	The Relic Isaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.	Little Gish Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.	Little Steven Spawns a familiar that follows Isaac around and fires homing tears.	The Halo Grants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.	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.	The Common Cold Adds a chance to shoot poison tears, dealing damage over time when inflicted.
The Parasite Isaac's tears split in two when they hit something.	The D6 Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.	Mr. Mega Gives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.	The Pinking Shears Separates Isaac's head and body for the current room. Isaac's head, which now has flight, will be under the player's control, while his body will seek out enemies to attack by contact damage.	The Wafer All sources of damage that would cause more than one half heart of damage are reduced to one half heart instead.	Money = Power Increases damage by 0.04 for every coin Isaac has, up to +3.96 damage at 99 coins.	Mom's Contacts Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.	The Bean Isaac releases bad gas, poisoning any enemy in close vicinity.	Guardian Angel Spawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies, and increases the speed of all orbital familiars.	Demon Baby Follows Isaac and automatically fires at enemies in its reach.	Mom's Knife 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.	Ouija Board Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.	9 Volt Reduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges.	Dead Bird Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.	Brimstone Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.	Blood Bag Grants one red heart container, restores 5 red hearts, and increases speed by 0.3.	Odd Mushroom +1.7 tears, +0.3 speed, reduces damage.	Odd Mushroom Grants an empty heart container. Increases damage, range and shot height while reducing speed.	Whore of Babylon Increases damage and speed whenever Isaac has half a red heart or less (one red heart for Eve), ignoring any soul or black hearts.	Monster Manual Summons a random familiar for the current room. Can summon familiars not yet unlocked.
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Dead Sea Scrolls Triggers the effect of a random activated item from a list of possible options (not every activated item is included).	Bobby-Bomb Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.	Razor Blade Upon use, deals one heart of damage to Isaac and grants +1.2 damage for the current room.	Forget Me Now When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.	Forever Alone Spawns a blue attack fly that orbits a long distance from Isaac.	Bucket of Lard Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.	A Pony 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.	Bomb Bag Isaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.	A Lump of Coal The more distance tears travel, the more damage they will do.	Guppy's Paw Removes one red heart container in exchange for gaining 3 Soul Hearts.	Guppy's Tail Increases chance of finding gold chests and normal chests, but reduces chance of finding pickups.	IV Bag Upon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the blood donation machine.	Best Friend Deploys a decoy Isaac that eventually explodes with an increased blast radius.	Remote Detonator Bombs you place explode only when you use this item. Gives 5 bombs.	Stigmata Increases damage, and adds 1 heart container.	Mom's Purse Allows Isaac to hold 1 additional trinket.	Bob's Curse Gives 5 bombs and grants all bombs poison effect.	Pageant Boy Spawns several coins around Isaac.	Scapular Once per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.	Speed Ball Increases speed by 0.3 and shot speed by 20%.
Bum Friend A portable beggar who follows Isaac, picks up coins for himself, and occasionally drops a pickup after collecting a coin. Does not spawn collectibles.	Guppy's Head Spawns 2-4 blue flies to damage enemies.	Prayer Card Grants an eternal heart per use.	Notched Axe Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.	Infestation 1-3 blue flies randomly spawn every time Isaac gets hit.	Ipecac Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.	Tough Love Adds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.	The Mulligan Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.	Technology 2 Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.	Mutant Spider Grants quadruple shot but decreases tears.	Chemical Peel Tears fired from left eye do increased damage.	The Peeper Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to Boom Flies damaging enemies it passes through.	Habit When Isaac is hit, 1 point of an item's charge is filled.	Bloody Lust Increases damage as Isaac receives damage. Damage increase stays for the whole floor.	Crystal Ball Reveals the map (except the Super Secret Room) and drops a random Tarot Card or soul heart.	Spirit of the Night Grants spectral tears and flight.	Crack the Sky Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.	Ankh Upon death, the player will respawn as ??? with 3 soul hearts.	Celtic Cross Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.	Ghost Baby Spawns a familiar that follows Isaac around and fires spectral tears.
The Candle Throws out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.	Cat-O-Nine-Tails Increases Shot Speed and damage.	D20 Rerolls all pickups in the current room.	Harlequin Baby Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.	Epic Fetus Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.	Polyphemus Makes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.	Daddy Longlegs Daddy Long Legs' shadow follows Isaac and stomps on enemies.	Spider Butt Damages all enemies in the room and slows them and their projectiles down.	Sacrificial Dagger Dagger orbits Isaac, dealing very high damage.	Mitre Grants a chance of converting any red hearts pickups into soul hearts instead.	Rainbow Baby Spawns a familiar that follows Isaac around and fires tears with random effects.	Dad's Key Opens all doors in the current room when activated, including doors which require a key to open and entrances to secret rooms. Opens the big doors in the first room of both The Chest and the Dark Room.	Stem Cells Adds one filled heart container and increases Shot Speed.	Portable Slot Upon activation, 1 coin will be consumed, and a random pickup may drop, similar to the slot machine.	Holy Water 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.	Fate Grants flight and one eternal heart.	The Black Bean When taking damage, Isaac farts, causing poison damage to all enemies in range.	White Pony 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 while also casting the effect of Crack the Sky.	Sacred Heart Increases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.	Toothpicks +0.7 tears, +16% shot speed.
Holy Grail Grants flight and one heart container.	Dead Dove Grants spectral tears and flight.	Blood Rights Damages all enemies in the room, but deals a heart of damage to Isaac with each use.	Guppy's Hair Ball Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.	Abel A familiar that mirrors the player's movements and shoots in the opposite direction.	SMB Super Fan Increases all stats.	Pyro Adds 99 bombs.	3 Dollar Bill Gives Isaac a random tear effect every room. The effect given changes upon entering a room. The effect changes every 3 seconds.	Telepathy for Dummies Upon activation, grants homing tears for the current room.	MEAT! Adds a heart container and increases damage.	Magic 8 Ball Increases Shot Speed, and drops a Tarot Card when picked up.	Mom's Coin Purse Spawns 4 random pills around Isaac.	Squeezy Increases tears by 0.4, and spawns 2 Soul Hearts pickups.	Jesus Juice Increases Damage and Range.	Box Spawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.	Mom's Key Spawns 2 keys. Generates additional pickups from chests.	Mom's Eyeshadow Tears have a chance to charm enemies.	Iron Bar Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.	Midas' Touch Enemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.	Humbling Bundle Gives one extra pickup (1+1 Free version) of Red Hearts, pennies, bombs, and keys. Does not work with blue, black, and half red hearts, nickels, and dimes.
Fanny Pack Has a chance to drop a random pickup when Isaac takes damage.	Sharp Plug Using an activated item while it's not charged will charge it and Sharp Plug does 2 full heart damage to Isaac.	Guillotine Isaac's head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.	Ball of Bandages 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.	Champion Belt Increases damage, but also increases the chance of champion enemies appearing.	Butt Bombs Gives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.	Gnawed Leaf After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.	Spider Baby When hit, spawns up to 2 blue spiders.	Guppy's Collar Grants Isaac a permanent 50% chance to respawn with 1/2 of a red heart after death.	Lost Contact Every tear has a small shield which will allow it to block one enemy projectile.	Anemic +5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.	Goat Head A Devil Room / Angel Room Door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.	Ceremonial Robes Adds 3 black hearts and increases Damage by 1.	Mom's Wig Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.	Placenta Grants a full heart container, and a chance to regenerate a half-heart of health every minute of gameplay.	Old Bandage Adds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.	Sad Bombs +5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.	Rubber Cement Tears bounce off walls, enemies, and environmental objects.	Anti-Gravity -2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.	Pyromaniac Isaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.
Cricket's Body Grants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.	Gimpy 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.	Black Lotus Grants the player one red heart container, one soul heart, and one black heart.	Piggy Bank Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.	Mom's Perfume Adds a chance to shoot fear tears and decreases tear delay by 1.	Monstro's Lung Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.	Abaddon Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.	Ball of Tar Adds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies' speed.	Stop Watch Automatically inflicts slow to all enemies in every room. Upon taking damage, inflicts slow to all enemies for the current room.	Tiny Planet Range up and makes shot tears revolve around Isaac until they drop.	Infestation 2 Spawns allied blue spiders from killed enemies.	E Coli Gives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.	Death's Touch Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.	Key Piece 1 Combined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.	Key Piece 2 Combined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.	Experimental Treatment Randomly increases and decreases some of the character's stats.	Contract From Below Doubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.	Infamy Chance to block projectiles coming from any direction.	Trinity Shield Isaac gains a shield that protects him from enemy shots.	Tech.5 Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.
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20/20 Grants double shot.	Blue Map Shows secret and super secret room locations on the map.	BFFS! Increases the size and damage of familiars.	Hive Mind Increases the size of blue spiders and blue flies and doubles the amount of damage they deal.	There's Options There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.	Bogo Bombs All standard bomb pickups become 1+1 bomb pickups.	Starter Deck Isaac can hold 2 cards at once and all pills are replaced by cards.	Little Baggy Isaac can hold 2 pills at once and all cards are replaced by pills.	Magic Scab Increases luck and HP by 1.	Blood Clot Increases damage by 1 and range by 5 for tears fired from the left eye.	Screw +0.5 tears up, +0.2 shot speed up.	Hot Bombs Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.	Fire Mind 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.	Missing No. Randomizes all passive items upon pickup and at the start of each succeeding floor.	Dark Matter Increases Damage by 1 and adds a chance to shoot fear tears.	Black Candle Prevents curses. Grants one black heart. Increases the chance for a Devil or angel room to appear.	Proptosis Tears start out massive with high damage, and then shrink down and become weaker over a short range.	Missing Page 2 Gives 1 black heart. Upon taking damage that reduces Isaac's health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.	Smart Fly After Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.	Dry Baby Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.
Juicy Sack A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.	Robo-Baby 2.0 Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.	Rotten Baby A familiar that spawns blue flies.	Headless Baby Familiar that follows Isaac, leaving blood creep on the ground.	Leech Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.	Mystery Sack Spawns a familiar that follows Isaac around and has a chance to drop a heart, coin, bomb, or key after clearing a room.	BBF Spawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.	Bob's Brain Spawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.	Best Bud When hit, summons a white attack fly similar to Distant Admiration for the current room.	Lil Brimstone A Familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.	Isaac's Heart Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.	Lil Haunt A familiar that damages enemies by chasing them as well as inducing the fear effect.	Dark Bum 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.	Big Fan Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.	Sissy Longlegs Wanders about the room, occasionally spawning blue spiders.	Punching Bag Spawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.	How to Jump Gives Isaac the ability to jump (over gaps, spikes, etc.).	D100 Upon use, rerolls all passive items on Isaac like the D4, every pedestal item in the room like The D6, and every pickup like the D20.	D4 Rerolls all of Isaac's items.	D10 Rerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).
Blank Card Has the same effect as the card or rune currently held by Isaac.	Book of Secrets Upon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.	Box of Spiders Summons 2-4 blue spiders.	Red Candle Throws a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots.	The Jar When at full health, up to 4 extra hearts can be stored in the jar.	Flush! Changes all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.	Satanic Bible Upon activation, Isaac gains a black heart.	Head of Krampus Fires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot.	Butter Bean Isaac farts and pushes back nearby enemies.	Magic Fingers For 1 coin, damages all enemies in the room.	Converter When used, converts two soul hearts into a heart container.	Pandora's Box Upon use, spawns certain pickups or items depending on the floor it is used on. Single-use.	Unicorn Stump Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.	Taurus Speed down; gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.	Aries +0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.	Cancer Adds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.	Leo Allows you to crush rocks when you walk over them.	Virgo Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills".	Libra Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.	Scorpio Grants poison tears, which deal damage over time when inflicted.
Sagittarius Increases speed by +0.2 and grants piercing tears.	Capricorn All stats up.	Aquarius A trail of blue creep is left behind Isaac, which damages enemies.	Pisces -1 Tear Delay, adds knock-back shots and increases tear size.	Eve's Mascara Doubles damage, halves tears stat, and greatly reduces shot speed.	Judas' Shadow Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.	Maggy's Bow Gives one heart container and doubles the healing provided by red hearts.	Holy Mantle Automatically negates first taken damage in every room.	Thunder Thighs Destroys rocks upon contact with Isaac. Adds one heart container and lowers Speed.	Strange Attractor Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.	Cursed Eye Grants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.	Mysterious Liquid Tears leave a small, short lasting pool of creep on impact or when their range is depleted.	Gemini Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.	Cain's Other Eye Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.	???'s Only Friend Summons a big attack fly that can be controlled with the shooting direction-keys.	Samson's Chains Pull a chain and ball behind you that will damage enemies on contact and is able to break stones.	Mongo Baby Summons a familiar that copies the tears of Isaac's other familiars.	Isaac's Tears Shoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.	Undefined Teleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.	Scissors Upon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.
Breath of Life Grants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage.	The Polaroid 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.	The Negative If the character has half a red heart or no red hearts after taking damage, it triggers The Necronomicon effect, damaging all enemies in the room. Also allows entrance into the Dark Room.	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.	Soy Milk Tears shrink and do much less damage, but fire in very rapid succession.	Godhead Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.	Lazarus' Rags Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.	The Mind Grants the combined effects of the Blue Map, Treasure Map, and The Compass, revealing the floor layout and all special rooms, including Secret Rooms and Super Secret Rooms.	The Body Adds 3 heart containers.	The Soul Grants two soul hearts. Isaac now repels enemy projectiles.	Dead Onion Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.	Broken Watch 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.	The Boomerang Throws a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups.	Safety Pin Increases range and shot speed, while adding 1 Black Heart.	Caffeine Pill Increases speed and reduces character size. Also gives a random pill.	Torn Photo Tears + Shot speed up.	Blue Cap Grants 1 heart container and increases tears, but decreases shot speed.	Latch Key Increases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.	Match Book Grants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.	Synthoil Increases damage by 1, range by 5.25, and tear height by 0.5.
A Snack Grants one full red heart container.	Diplopia Duplicates all pickups and item pedestals in the room.	Placebo When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.	Wooden Nickel When used, has a 50% chance to drop one random type of coin (penny, nickel, or dime).	Toxic Shock Upon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground.	Mega Bean 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.	Glass Cannon When used, reduces Isaac's health to half a heart (including soul and black hearts) and fires one large piercing spectral tear that does a lot of damage. The damage done by Glass Cannon scales with Isaac's damage (at base damage it does 45 damage).	Bomber Boy +5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects troll bombs.	Crack Jacks Adds one heart container and drops a random trinket.	Mom's Pearls +1.25 Range Up. +0.5 Tear Height. +1 Luck Up.	Car Battery Causes Isaac's activated item to activate twice on each use.	Box of Friends Upon use, duplicates all of Isaac's familiars for the current room.	The Wiz Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard? pill. Isaac's tears also travel above all obstacles.	8 Inch Nails +1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.	Incubus A demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.	Fate's Reward A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.	Lil Chest Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.	Sworn Protector An orbital angel which does 7 contact damage per tick and blocks enemy shots. Upon blocking 10 shots in a room it drops an eternal heart.	Friend Zone 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.	Lost Fly A familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact with in each room. If any enemies walk into its path, it will deal 7 contact damage per tick. If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously travelling until it meets another wall or obstacle.
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Scatter Bombs Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.	Sticky Bombs +5 bombs. Bombs stick to enemies and spawn 2-4 blue spiders if they kill an enemy.	Epiphora Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.	Continuum +2.25 Range Up. +1.5 Tear Height. Isaac's tears travel through walls and appear out of the opposite wall. Isaac's tears also travel over rocks and objects.	Mr. Dolly Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.	Curse of the Tower Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.	Charged Baby A familiar that drops a Little Battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.	Dead Eye Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.	Holy Light Isaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.	Host Hat A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.	Restock Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.	Bursting Sack Spider enemies no longer target or deal contact damage to Isaac.	No. 2 Continuously firing tears for several seconds causes Isaac to drop a Butt Bomb. Butt Bombs explode for 50 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time.	Pupula Duplex Transforms Isaac's tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).	Pay to Play This item turns all doors that require a key into doors which need a coin to enter instead. This affects shops, item rooms, libraries and other key doors.	Eden's Blessing +0.7 tears up. Grants a random item at the start of the next run.	Friendly Ball Throwing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be friendly, fighting for Isaac and persisting between rooms.	Tear Detonator When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.	Lil Gurdy Gives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.	Bumbo Spawns a beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, dealing contact damage.
D12 Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.	Censer Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.	Key Bum Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.	Rune Bag A bag that follows Isaac and drops a random rune every 3 rooms.	Seraphim An angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.	Betrayal Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.	Zodiac Zodiac will give Isaac a random zodiac item effect that changes after every floor.	Serpent's Kiss Tears now have a random chance to apply a poison effect, causing 4 or 6 damage per tick to enemies (Similar to The Common Cold item). Isaac now deals poison damage on contact with enemies similar to The Virus item (Damage over time 4 or 6 per tick). Enemies that were poisoned have a chance to drop a black heart when killed.	Marked Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360 degree tear firing radius. Can be overridden by other tear modifiers such as Mom's Knife or Brimstone.	Tech X Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.	Ventricle Razor Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.	Tractor Beam Isaac emits a beam from his face. Isaac's tears travel in the path of the beam.	God's Flesh Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.	Maw of the Void +1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.	Spear of Destiny In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.	Explosivo Isaac's tears have a chance to stick to enemies and explode.	Chaos Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.	Spider Mod Displays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.	Farting Baby A familiar that follows Isaac and blocks tears. If a tear hits Farting Baby, there is a high chance for it to fart, which will either knock back, poison, or charm all nearby enemies.	GB Bug A glitch familiar that bounces around the room and applies a random status effect to any enemies it comes into contact with and has a chance to re-roll pickups that it passes over.
D8 Re-rolls Isaac's speed, range, tears, and damage.	Purity This item will boost one of Isaac's stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.	Athame Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.	Empty Vessel While Isaac has no red hearts, this item grants flight and a random chance to activate an invincibility shield for a few seconds. If Isaac gains any red hearts, these benefits will disappear.	Evil Eye While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle.	Lusty Blood Each time Isaac kills an enemy, Isaac's damage increases for the current room.	Cambion Conception After taking damage a certain amount of times, a permanent demonic familiar spawns.	Immaculate Conception Upon picking up a certain amount of health, spawn a permanent angelic familiar.	More Options Two items spawn in every Treasure Room. Only one can be taken; the other will disappear.	Crown of Light Gives Isaac a crown that glows blue when active, and turns gray when inactive. While Isaac has no empty red heart containers, Isaac's tears are replaced with blue diamond tears that deal double damage. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.	Deep Pockets Allows Isaac to carry two cards or pills (or a combination of both) at the same time.	Succubus Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.	Fruit Cake Isaac's tears gain a random effect that changes every shot.	Teleport 2.0 When used, teleports Isaac to a random room that has not been explored yet. If all rooms are explored, including secret rooms, it will teleport Isaac to the Devil or Angel room. If all rooms are explored, including the Devil or Angel room, it will teleport Isaac to the I AM ERROR room. If used in a room with enemies, it will teleport Isaac out and back into the exact same room.	Black Powder Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.	Kidney Bean Upon use, Isaac farts, charming all nearby enemies.	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.	Circle of Protection Surrounds Isaac with a large white halo around him that pulsates. With each pulse, the halo deals contact damage to enemies equal to Isaac's damage. Each pulse also converts any enemy shots touching the ring into friendly purple homing tears.	Sack Head Greatly increases the chance to find sacks.	Night Light A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
Obsessed Fan A purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.	Mine Crafter When used, places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.	PJs Grants four soul hearts and fully restores Isaac's red health.	Head of the Keeper Isaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.	Papa Fly A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.	Multidimensional Baby Spawns a familiar that will follow Isaac's movements on a 2.5 second delay. Tears that pass through the baby will be doubled and increase in speed.	Glitter Bombs Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.	My Shadow Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black friendly Charger that will attack enemies. The Charger will be killed if it is damaged too much.	Jar of Flies Every time Isaac kills an enemy, a fly will be added to the jar, up to a maximum of 20. Using the Jar of Flies will release all the flies that are currently in the jar as friendly blue flies that will damage enemies.	Lil' Loki A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.	Milk! A glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the rest of the room.	D7 Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.	Binky Tears up, adds 1 soul heart, and decreases Isaac's size.	Mom's Box When used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.	Kidney Stone 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.	Mega Blast Upon use, Isaac fires a laser similar to the one used by Mega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active.	Dark Prince's Crown Increases range, tears, and shot speed when at exactly one red heart.	Apple! Increases tears. Adds a chance to fire a high-damage razor blade.	Lead Pencil After every 15 tears fired, Isaac will fire a high-damage cluster of tears.	Dog Tooth Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Dead Tooth While firing, Isaac gains a green aura that poisons nearby enemies.	Linger Bean Adds a chance to fire a gas cloud that damages nearby enemies.	Shard of Glass Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.	Metal Plate Adds a chance to reflect enemy shots. Grants one soul heart.	Eye of Greed Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.	Tarot Cloth Drops a random card or rune. Doubles the effects of cards and runes.	Varicose Veins Taking damage releases a ring of 10 high damage tears.	Compound Fracture Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.	Polydactyly Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.	Dad's Lost Coin Increases range by 1.5. Drops a lucky penny.	Moldy Bread Grants one full red heart container.	Cone Head Grants a soul heart. Adds a chance to block enemy shots.	Belly Button Drops a random trinket. Grants a second trinket slot.	Sinus Infection Adds a chance to fire a booger which sticks to enemies and poisons them.	Glaucoma Adds a chance to shoot concussive tears, causing enemies to walk around randomly.	Parasitoid Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.	Eye of Belial Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.	Sulfuric Acid Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.	Glyph of Balance Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.	Analog Stick +0.3 tears up. Allows Isaac to fire tears diagonally.
Contagion The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.	Finger! Spawns a finger familiar that points at enemies, dealing constant damage.	Shade Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies.	Depression Spawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.	Hushy Spawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.	Lil Monstro Spawns a familiar that fires clusters of tears. Must be charged before shooting.	King Baby Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.	Big Chubby Spawns a familiar that slowly charges forward and damages enemies in its path.	Tonsil Grants a familiar that can block enemy shots.	Plan C Kills all enemies in the room, then kills Isaac three seconds later.	D1 Duplicates a random pickup in the room.	Void Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades.	Pause Freezes all enemies until a fire button is pressed.	Smelter Consumes Isaac's currently held trinket and applies its effect permanently.	Compost Spawns a blue spider or fly. Turns pickups in the room into blue spiders or flies.	Dataminer Displaces enemy sprites for the current room, randomly increases one stat and decreases another.	Clicker Transforms Isaac into another random character.	Mama Mega! Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor's secret and super secret rooms.	Wait What? Isaac farts, sending out rock waves.	Crooked Penny Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.
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Dull Razor Hurts Isaac without depleting health, activating any items that trigger upon taking damage.	Potato Peeler Removes a heart container, increases damage and range, and grants a Cube of Meat.	Metronome Grants a random item effect for the current room.	D Infinity Grants a random dice item that changes each use.	Eden's Soul Spawns two item pedestals.	Acid Baby Spawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.	YO LISTEN! +1 luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.	Adrenaline Increases damage based on how many empty heart containers Isaac has.	Jacob's Ladder Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.	Ghost Pepper Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.	Euthanasia Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.	Camo Undies Isaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.	Duality Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.	Eucharist An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.	Sack of Sacks Spawns a sack familiar that has a chance to drop a sack upon clearing a room.	Greed's Gullet Grants a heart container for every 25 coins Isaac has.	Large Zit Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.	Little Horn Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.	Brown Nugget Spawns a stationary fly familiar that fires tears at nearby enemies.	Poke Go Upon entering a room with enemies in it, has a chance to spawn a random friendly enemy that persists across rooms.
Backstabber Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.	Sharp Straw Damages all enemies in the room.	Mom's Razor Spawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.	Bloodshot Eye Spawns an orbiting eye familiar that fires tears every 2 seconds.	Delirious Spawns a random charmed boss.	Angry Fly Spawns a fly familiar that orbits around a random enemy and deals 5 damage per tick to enemies it comes in contact with.	Black Hole Throws a black hole on the ground which sucks in and damages enemies.	Bozo Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.	Broken Modem Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.	Mystery Gift Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead.	Sprinkler Upon use, spawns a sprinkler that rotates and fires tears.	Fast Bombs Grants 7 bombs and allows bombs to be placed rapidly.	Buddy in a Box Grants a familiar with a random tear effect. The familiar is randomized at the start of each floor.	Lil Delirium Grants a familiar that transforms into another random familiar every 10 seconds.	Jumper Cables Grants an active item charge every 15 enemies killed.	Coupon Upon use, makes a random item from a shop, devil deal, or black market free.	Telekinesis Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears.	Moving Box If the box is empty, picks up all items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room.	Technology Zero Connects Isaac's tears with electricity that can damage enemies.	Leprosy Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.
7 Seals Grants a random Harbinger familiar that changes every 10 seconds.	Mr. ME! Summons a controllable ghost that can perform various tasks depending on what it targets.	Angelic Prism Grants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.	Pop! Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.	Death's List Grants a reward if all enemies in a room are killed in the order they are marked.	Haemolacria Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.	Lachryphagy Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.	Trisagion Tears are replaced with piercing white blasts of light.	Schoolbag Allows Isaac to hold two active items.	Blanket Grants one soul heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.	Sacrificial Altar Upon use, sacrifices up to 2 familiars and spawns an item from the Devil Room Pool for each familiar sacrificed.	Lil Spewer Spawns a random pill, and grants a small Spewer familiar that charges up and fires different types of creep.	Marbles Spawns 3 random trinkets. Taking damage has a small chance to swallow Isaac's currently held trinket, gaining its effect permanently.	Mystery Egg Spawns an egg familiar, which cracks and turns into a random friendly enemy when Isaac is hurt. The egg regenerates upon entering a different room.	Flat Stone Tears bounce off the floor. Tears that hit an enemy after bouncing deal splash damage to all nearby enemies for 25% of Isaac's tear damage.	Marrow Grants one bone heart and spawns three red heart pickups.	Slipped Rib Spawns a bone familiar that circles around Isaac and reflects enemy shots.	Hallowed Ground Spawns a white poop familiar, which turns into a white poop when Isaac is hurt.	Pointy Rib Spawns a bone familiar that can be aimed with the fire buttons and does contact damage.	Book of the Dead Upon use, spawns a friendly Bony or an orbital bone for each enemy killed in the current room.
Dad's Ring Creates a ring of light around Isaac that petrifies enemies in contact.	Divorce Papers Spawns a Mysterious Paper, increases tears, and grants a bone heart.	Jaw Bone Spawns a familiar that flies the room while firing, dealing a flat 7 damage to enemies that come in contact and retrieving pickups.	Brittle Bones Replaces all red hearts with 6 empty bone hearts. Upon losing a bone heart, Isaac fires bones in 8 directions and permanently gains a tears up.	Broken Shovel While held, causes multiple Mom's Foots to come down and stomp on Isaac. One of two parts necessary to create Mom's Shovel.	Broken Shovel One of two parts necessary to create Mom's Shovel.	Mom's Shovel 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.

Trivia

• The item order is based on The Binding of Isaac and its expansion up to item 198.