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Parasitoid is a passive item added in Afterbirth †.
- Adds a chance to fire an egg sack which spawns slowing creep. If an egg sack hits an enemy, a blue fly or blue spider is spawned.
- Egg sack tears have considerably higher tear height and consequently, range.
- Egg sacks will also spawn blue flies or spiders if they hit fireplaces or invincible enemies like Death's Head and Stoney.
- The chance to fire an egg sack is affected by luck but cannot reach 100% at high luck.
- 20/20Grants double shot./ The Inner EyeGrants triple shot but decreases tears./ Mutant SpiderGrants quadruple shot but decreases tears.: All tears have a chance of becoming an egg sack.
- Angelic PrismGrants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.: Egg sacks will be quadrupled when passing through the prism.
- Compound FractureIncreases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle./ 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.: When egg sacks are fired, they will split into smaller egg sacks. Split egg sacks from The Parasite will not look like egg sacks.
- 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.: Egg sacks bounce against floor.
- GodheadIncreases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.: Egg sacks retain damaging aura and homing effect.
- Hive MindIncreases the size of blue spiders and Blue Flies and doubles the amount of damage they deal.: Flies and spiders are bigger and deal double damage.
- Homing Tears: Egg sacks will home in on enemies.
- IncubusA demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.: Familiar can fire egg sacks.
- Kidney StoneRandomly 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.: Every tear in the tear barrage and the stone has a chance to be an egg sack.
- Lead PencilAfter every 15 tears fired, Isaac will fire a high-damage cluster of tears./ Monstro's LungIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.: Each tear in tear barrage has a chance to be an egg sack.
- 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.: Tear's appearance doesn't change, but it gains a chance to spawn slowing creep, flies and spiders on occasion.
- Rubber CementTears bounce off walls, enemies, and environmental objects.: Egg sacks bounce and apply their effects on each hit on enemies.
- Varicose VeinsTaking damage releases a ring of 10 high damage tears.: Every tear fired when taking damage has a chance to be an egg sack.
- Azazel: Parasitoid has no effect.
- 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.: Overrides Parasitoid.
- Dr. FetusTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.: Overrides Parasitoid.
- Epic FetusIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.: Overrides Parasitoid.
- 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 retain Haemolacria appearance and only the main tear can spawn flies or spiders when damaging enemies.
- IpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.: Only extra range applies on egg sack tears and they will not spawn flies or spiders.
- LachryphagyIsaac'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.: Fed tears have a chance of being egg sacks or normal tears. Fed egg sacks will burst and each burst tear has a chance of being a egg sack.
- Mom's KnifeIsaac'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.: Overrides Parasitoid.
- 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 Parasitoid.
- TechnologyReplaces tears with a piercing laser with unlimited range.: Overrides Parasitoid.
- TrisagionTears are replaced with piercing white blasts of light.: Overrides Parasitoid.
- Parasitoid is a term for when insects' larvae live inside their hosts as a parasite before eventually killing the host.