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IV Bag is an activated item.
- When activated, causes Isaac to lose half a heart (or a full heart in The Womb and beyond) while spawning 1-3 coins.
- This effect is counted as inflicted damage for the purpose of items that spawn pickups upon damage, such as Gimpy or Fanny Pack, but does not count against the chance of encountering the Devil Room.
- Invulnerability will not prevent Isaac from losing hearts.
- Spawns 0-1 coins when playing as Keeper.
- If down to half a heart (or a full heart in The Womb and beyond), it will take soul or black hearts instead of red hearts.
- When playing as the Lost, using the item will be an instant kill through Holy Mantle.
- Since using the IV Bag still causes invulnerability, using it just before getting hit, walking over spikes, or going through a Sacrifice Room will grant coins without inflicting extra damage.
- Bloody Penny: IV Bag's pennies have a chance to spawn half red hearts, allowing IV Bag to be used more.
- Infestation: Spawns Blue Flies whenever IV Bag is used.
- Isaac's Heart: Can be used without taking damage, resulting in an infinite amount of coins.
- Isaac still takes damage from this during The Guardian challenge.
- Piggy Bank/ Swallowed Penny: Extra coins will appear when Isaac uses IV Bag.
- Piggy Bank will spawn 0-1 when the player is playing with Keeper.
- Spider Baby: Spawns Blue Spiders whenever IV Bag is used.
- The Wafer: Even in The Womb and beyond, IV Bag only takes half a heart.
- Scapular: Allows for infinite coins once Isaac is at half a red heart (or full red heart in The Womb or beyond) by moving between rooms to reset Scapular's effect.
- Portable Slot: Can be alternated between to gain ridiculous amounts of pickups from only a few initial coins or hearts.
3DS The icon of IV Bag as seen on the lower 3DS screen
- A glitch in the original Binding of Isaac existed where the player could leave a room and activate the item during the invincibility frames offered during recovery of using the items, effectively spawning infinite coins. This bug has been fixed in The Binding of Isaac: Rebirth.