Trisagion is an unlockable passive item added in Booster Pack #4.
- Tears are replaced with piercing white blasts of light.
- Blasts deal 33% of regular tear damage, but can hit the same enemy multiple times.
- Blasts do not knock back enemies.
- Since the blasts can strike one enemy multiple times, low shot speed can be very beneficial whereas high shot speed may lower effective damage.
- Walking backwards while firing can allow tears to move slower, making it useful for increasing damage output.
- 8 Inch Nails+1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback. / BlisterIncreases knockback of tears. / Pisces-1 Tear Delay, adds knock-back shots and increases tear size.: Adds knockback to blasts, which can not only significantly repel enemies when used correctly, it can deal a high amount of damage to enemies unable to escape the knockback.
- Chocolate MilkGrants charged tears that deal greater damage when fully charged.: Fully charged Trisiagon blasts deal 4 times more damage, exceeding Isaac's base damage.
- GodheadIncreases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.: Although the damaging aura isn't visible, it still exists and is not affected by Trisagion's damage reduction.
- Guppy (Transformation): As it hits multiple times, it spawns multiple flies per tear making it very strong.
- IpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.: Ipecac's damage boost applies; the light beam causes explosions dealing full damage when it impacts something or runs out of range. Use with caution. Having PyromaniacIsaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs. or Host HatA host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions. is recommended.
- 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.: The beam becomes controllable, still dealing reduced damage but at very high rate.
- My ReflectionGives Isaac's tears a boomerang effect, and increases range and shot speed.: In addition to the usual effect, lengthens the Trisagion blasts into short flexible beams for a much larger damage-dealing area.
- Mysterious LiquidTears leave a small, short lasting pool of creep on impact or when their range is depleted.: Causes a large trail of creep. The effect stacks, which causes heavy damage (even to Hush).
- ProptosisTears start out massive with high damage, and then shrink down and become weaker over a short range.: Base damage is doubled and beam damage is boosted to about 65%. Blasts lose no power as they travel further, though the tips of the blasts deal very slightly less damage.
- Azazel: Azazel's short range Brimstone overrides Trisagion.
- 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 Trisagion.
- 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./ Compound FractureIncreases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle./ The ParasiteIsaac's tears split in two when they hit something.: Split blasts are not generated on hitting enemies, only on obstacles and walls, as well as floors for Cricket's Body.
- Dead EyeIsaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.: Overridden by Trisagion.
- Dr. FetusTears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.: Overrides Trisagion.
- Epic FetusIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.: Overrides Trisagion.
- Eye of BelialGrants piercing tears. After piercing one enemy, tears start homing and deal double damage.: Overridden by Trisagion.
- 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.: Blasts continually disappear and reappear as they "bounce". The bounces deal 25% splash damage based on Isaac's base rating, but the blasts cannot do their damage while they're disappearing, leading to an overall reduced effeciency.
- Holy LightIsaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.: Overridden by Trisagion.
- Jacob's LadderTears fire sparks of electricity in random directions upon hitting an obstacle or enemy.: Electric arcs are not generated on hitting enemies, only on obstacles and walls.
- 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.: The blasts will slow down and float like Lachryphagy tears and eventually burst, but can not consume each other.
- A Lump of CoalThe more distance tears travel, the more damage they will do.: Nearly no effect; increases damage by around 5% when the hit is dealt by the tip of the blast.
- A Lump of Coal + My Reflection: As the beam is longer, the amount of extra damage at the tip can be up to around 50%.
- 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 Trisagion.
- Multidimensional BabySpawns a familiar that will follow Isaac's movements on a 2.5 second delay. Tears that pass through the baby will be doubled and increase in speed.: The baby cannot duplicate Trisagion blasts.
- ParasitoidAdds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.: Overridden by Trisagion.
- 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.: The blasts will slow down and float like Pop! tears, but will not bounce off each other.
- Sinus InfectionAdds a chance to fire a booger which sticks to enemies and poisons them.: Overridden by Trisagion.
- 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 Trisagion.
- TechnologyReplaces tears with a piercing laser with unlimited range.: Overrides Trisagion.
- Technology ZeroConnects Isaac's tears with electricity that can damage enemies.: Unless Isaac has shooting familiars, Technology Zero will not function. Familiars' tears will be connected to the blasts with electricity, however.
- Trisagion is based on this Steam Workshop item by x Wyvern x and TRPG, originally known as Lightshot.
- The name is a reference to one of the oldest christian hymns.
| 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 The 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.