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- x2.3 damage multiplier.
- +1 flat damage.
- +4.125 range.
- +0.75 tear height.
- -0.4 tears.
- -25% shot speed.
- Grants homing tears.
- Grants homing bombs (the effect of Bobby-BombGives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.).
- Grants one heart container.
- Replenishes all red hearts.
- 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.: Blood beam gets a large damage boost and curves towards enemies.
- Azazel: The short-ranged beam can curve if Azazel gets enough range upgrades.
- GodheadIncreases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.: The aura around the tears becomes larger and the damage caused is greatly increased.
- 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.: Damage increased and knife homes onto enemies.
- Mutant SpiderGrants quadruple shot but decreases tears.: All four tears home on enemies causing massive damage. Can instantly kill most enemies in one shot.
- TechnologyReplaces tears with a piercing laser with unlimited range.: The laser curves towards enemies.
- Although this item increases range, the reduction of shot speed results in a slight decrease in effective range, not accounting for homing.
K4X2 K1K0 (4th floor angel room) MJ0A X38C (4th floor angel room) 6FR2 46G3 (4th floor angel room)