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| Collect 10 "tears up" items or pills in one runLachryphagy
Lachryphagy is an unlockable passive item added in Booster Pack #4.
- Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions.
- Hitting an enemy will not cause them to burst.
- Tears can be fired into other tears to feed them, increasing their damage and the damage of the burst tears.
- If one tear is fed 5 other tears, it will immediately burst.
- The tears will have their damage added together, with the first consumed tear giving additional damage.
- Tears in the burst will deal half the damage the main tear would have.
- Tear bursting can also happen from sheer shot size. With sufficiently high damage or several tear-size increasing items, the tears will burst almost immediately after firing.
- BrimstoneTears 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.: Lachryphagy does not affect regular Brimstone beams, but tears from other sources such as Isaac's TearsShoots 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. or Fate's RewardA blue head familiar that will follow Isaac and fire tears copying his tear effects and damage. will burst into 8 Brimstone beams.
- Dr. FetusTears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.: Overrides Lachryphagy.
- Epic FetusIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.: Overrides Lachryphagy.
- Flat StoneTears 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.: Overridden by Lachryphagy.
- The Ludovico TechniqueInstead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.: Overrides Lachryphagy.
- 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.: Tears behave erratically, with freshly fired tears usually behaving like Lachryphagy and burst tears like Pop!.
- Tech XTears 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.: Overrides Lachryphagy.
- TechnologyReplaces tears with a piercing laser with unlimited range.: Overrides Lachryphagy.
- TrisagionTears are replaced with piercing white blasts of light.: Tears will split but cannot be grown by feeding tears.
- 20/20Grants double shot./ The Inner EyeGrants triple shot but decreases tears./ Mutant SpiderGrants quadruple shot but decreases tears.: Tears tend to clump together soon after firing for high damage shots. It may take more than 5 tears in total to cause a burst.
- Compound FractureIncreases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.: Bone tears split into 8 tears, each of which can shatter into bone shards.
- Cricket's BodyGrants -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./ The ParasiteIsaac's tears split in two when they hit something.: Fed tears split into 12 tears.
- HaemolacriaTears 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.: Tears look like Hameolacria. They can be fed and will burst into 8 tears that have Haemolacria's burst effect upon hitting obstacles or enemies.
- A Lump of CoalThe more distance tears travel, the more damage they will do.: Tears continually grow in size without being fed other tears, but they will still only deal bonus damage based strictly on how far they travel. Burst tears will still grow in size and damage as they travel.
- Monstro's LungIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro. / Lead PencilAfter every 15 tears fired, Isaac will fire a high-damage cluster of tears.: The tears clump together soon after firing, causing potentially up to 20x base damage on a direct hit on an enemy.
- Sinus InfectionAdds a chance to fire a booger which sticks to enemies.: Boogers will always burst into more boogers, though some of the boogers may incorrectly appear to be normal tears. When a booger sticks to an enemy, it will burst into 8 boogers which have a high chance of sticking again to the same enemy.
- Tractor BeamIsaac emits a beam from his face. Isaac's tears travel in the path of the beam.: All split tears will travel along the beam.
- Lachryphagy is based on this Steam Workshop item by KittyK47, originally known as Hungry Tears.
- The name of this item is a reference to the behavior of insects, drinking tears of other creatures.
Lachryphagy tear growth, as they're being fed.
| Booster Packs
- 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.
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.
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.
- HairpinFully recharges Isaac's active item upon entering a boss fight.
- Wooden CrossGrants a Holy Mantle shield upon entering a new floor, which protects against one hit of damage.
- Butter!Using an active item will drop it onto a pedestal on the ground. Taking damage may result in dropping a passive item.
- Huge GrowthMakes Isaac large for the current room, increasing his range and damage.
- Ancient RecallSpawns 3 random cards.
- Era WalkFor the current room, enemies are slowed, Isaac's speed is increased, and his shot speed is decreased.
- Jumper Cables
Grants an active item charge every 15 enemies killed.
Upon use, makes a random item from a shop, devil deal, or black market free.
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.
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.
- Filigree FeatherAngels drop items instead of key pieces when defeated.
- 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.
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.
- Door StopThe last door Isaac went through stays open, allowing him to leave the room even if enemies are in it.
- Death's List
Grants a reward if all enemies in a room are killed in the order they are marked.
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.
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.
Tears are replaced with piercing white blasts of light.
Allows Isaac to hold two active items.
- Extension CordBeams of yellow electricity flow between Isaac and his familiars, damaging any enemies between them.
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.
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.
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 Dark Room.
- Rotten PennySpawns a blue fly every time a coin is picked up.
- Baby-BenderGrants Isaac's familiars homing shots.
- Finger BoneGrants a chance to gain a bone heart upon taking damage.