||Isaac farts, poisoning enemies around him.
||Injures Isaac by a full heart. If a Bad Trip pill is used while Isaac only has a single heart left or less, the pill will turn into a Full Health pill instead. (This damage counts as red heart damage for the purposes of getting a Devil Deal.)
||Balls of Steel
||Grants Isaac two soul hearts.
||Bombs Are Key
||Swaps the values of Isaac's bombs and keys.
||Spawns five active bombs behind Isaac over a period of five seconds, at one a second.
||Refills every empty red heart container.
||Removes one red heart container upon use. While Isaac has one or fewer red heart containers, it will act as a Health Up pill instead. ??? can encounter Health Down pills, even though he can't have red heart containers.
||Adds one empty red heart container upon use.
||I Found Pills
||Changes the appearance of Isaac's face. This pill is cosmetic only, and the effect disappears when you leave the room.
||Causes Isaac to grow four hairs from the top of his head and zits on his face. This pill is cosmetic only, and will stay for the rest of the run.|
Consuming three puberty pills will grant the Adult transformation.
||Grants 1 fly orbital that circles the player, blocking projectiles and damaging fly-type enemies on touch.
||Decreases Isaac's range by 2.
||Increases Isaac's range by 2.5.
||Decreases Isaac's movement speed by 0.12.
||Increases Isaac's movement speed by 0.15.
||Decreases Isaac's tears by 0.28.
||Increases Isaac's tears by 0.35.
||Decreases Isaac's luck by 1.
||Increases Isaac's luck by 1.
||Isaac gets teleported to a random room. Has a small chance to teleport Isaac to the I AM ERROR room, and an extremely small chance to teleport him to the black market, like UndefinedTeleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR..
||48 Hour Energy
||Drops one to two little batteries and fully charges the spacebar item. Can be used with the PlaceboWhen used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes. or D1Duplicates a random pickup in the room. to generate infinite batteries.
||Empties all but one red heart container and spawns 1-4 red hearts. If Isaac only has half of a heart left, it will heal him to one heart. If used without any red heart containers, no health will be deducted, but red hearts will still spawn. If used in a black heart or eternal heart-containing super secret room, it will spawn those types of hearts instead.
||Prevents Isaac from moving for a short duration.
||I can see forever!
||Opens all entrances to the secret room and super secret room for the current floor.
||Charms all enemies in the room for a short period of time.
||Replaces the floor map with a ? for the rest of the floor. If no other curses are active for the floor, the Curse of the Lost will appear under the level name when the map key is held. This effect cannot be negated by Black CandlePrevents curses. Grants one black heart. Increases the chance for a Devil or angel room to appear.. Also the only pill to have its flavour text appear on a piece of paper, like curses do.
||Spawns a large yellow pool (similar to Lemon MishapCreates a small yellow pool of creep, which damages enemies that cross it.) around your character. Greatly damages any enemy that steps on it, for 22 damage per tick or 66 damage per second.
||R U a Wizard?
||Tears are shot diagonally outwards for about 30 seconds. This effect does not reset upon exiting the room.
||Gives The WaferAll sources of damage that would cause more than one half heart of damage are reduced to one half heart instead. effect while in the room : reduces all damage taken to half a heart. Unlocked by completing Challenge #24: PAY TO PLAY.
||Makes Isaac take a full heart of damage from all sources for the current room. Also changes his appearance for the room. Unlocked by completing Challenge #24: PAY TO PLAY.
||For a short time, poop spawns wherever Isaac moves, like Explosive Diarrhea but with poop. A higher move speed means you can touch more tiles in the same time. A pun on laxatives. Unlocked by completing Challenge #25: Have a Heart.
||Gives the Curse of the Maze effect for the remainder of the floor. The effect can stack with other curses. If no other curses are active for the floor, Curse of the Maze will appear under the level name when Tab is held. This effect cannot be negated by Black CandlePrevents curses. Grants one black heart. Increases the chance for a Devil or angel room to appear.. As the pill's name is "???", the same as what unidentified pills are refered to, it is easy to accidentally use it more than once per run. It is recommended to memorize its color upon first using it. Unlocked by completing Challenge #25: Have a Heart.
||One makes you larger
||Increases Isaac's size and decreases the pitch of his voice. This effect does not increase the size of Isaac's hitbox, but will increase the size of The Forgotten's bone club. These pills contribute to the Stompy transformation.
||One makes you small
||Decreases Isaac's size and increases the pitch of his voice. This effect decreases the size of Isaac's hitbox.
||Destroys all poop in the room and spawns a single blue spider under Isaac and on each destroyed poop.
||Spawns blue spiders equal to the number of enemies in the room. If there are no enemies in the room, spawns 1-3 Blue Spiders.
||Activates an effect similar to The GamekidUpon 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..
||Briefly pixelates the screen 3 times over 30 seconds.
||Friends Till The End!
||Spawns three blue flies.
| Afterbirth †
||Creates a pool of slippery brown creep underneath Isaac.
||Creates a pool of black creep beneath Isaac.
||Upon use, slows all enemies for the duration of the room.
||Upon use, increases the speed of all enemies for the duration of the room. The effect triggers again 30 seconds after use and 60 seconds after use.
||Upon use, any trinkets that the player is holding are destroyed, and their effects are permanently applied to the player. Unlocked by acquiring the Once More With Feeling! achievement.
||Upon use, Isaac shoots an explosive tear with the IpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth. effect that always deals 200 damage.
Unlocked by acquiring the Dedication achievement.
|| Feels like I'm walking on sunshine!
||Temporarily makes Isaac invincible, similar to Unicorn StumpUpon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears..|
Unlocked by acquiring the Sin Collector achievement.
||Throws up the last pill you used. Will spawn itself if no other pills were taken beforehand.|
Unlocked by acquiring the U Broke It! achievement.