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Effects are one major mechanic of The Binding of Isaac: Rebirth. There are a number of different items that alter the type of tears and the status effects they inflict.

Status Effects

Status Effects are special effects that can be inflicted on an enemy from a variety of sources, such as tears, bombs, and items. Each status effect has a colour and symbol/effect associated with them for easy identification. These colourations are not to be confused with champions.

Effect Appearance Description
Burn Burn Effect Afflicted enemies take 4 to 6 fire damage over time, like poison. Afflicted enemies will be tinted orange for the duration and have a fire symbol above them.

(except in Rebirth) Afflicted enemies will sustain double Isaac's tear damage over time.

Charm Charm Effect Afflicted enemies will temporarily fight on Isaac's side, running toward other enemies and damaging them. If no other enemies are in the room, a charmed enemy will instead run towards Isaac. (Charmed enemies can still hurt Isaac.) Afflicted enemies will be tinted pink for the duration and have a heart symbol above them. Most enemies with ranged attacks will not fire them.

(in Afterbirth † and Repentance) Charmed enemies will prioritize non-charmed enemies and won't target invincible enemies. Charmed Portals will also spawn permanently-charmed enemies.

Confusion Confusion Effect Afflicted enemies are slowed and walk around randomly. While confused, most non-boss enemies will be unable to attack. Afflicted enemies will be tinted pale gray and have stars above them.
Fear Fear Effect Afflicted enemies are scared of Isaac and will run away from him. While scared, most non-boss enemies will be unable to attack or charge towards Isaac. Afflicted enemies will be tinted purple and have a skull symbol above them.
Petrified Stop Effect Afflicted enemies are stopped in place. They cannot move or attack. Afflicted enemies will be shaded brown-gray, as if turned to stone (unless petrified by Midas' Touch, in which case they will be shaded gold).
Poison File:Poison Effect.gif Afflicted enemies sustain 4 to 6 damage over time. Afflicted enemies will be tinted green and have a bubbly effect surrounding them.

(except in Rebirth) Afflicted enemies will sustain double Isaac's tear damage over time.

Slow File:Slow Effect.gif Afflicted enemies are slowed down. Any projectiles they shoot will also be slowed down. Attacks that end when the enemy runs out of momentum, such as the charging attacks of Gurdy Jr. and Dingle, will be vastly shortened in duration. Depending on the item that triggers the slow effect, afflicted enemies will be tinted black or white with a snail icon above them.
(except in Rebirth)
Shrink
Gaper Afflicted enemies are shrunken and will run away from Isaac. Isaac can walk over shrunken enemies to kill them.
(in Afterbirth † and Repentance)
Bleed
File:Bleed Effect.gif Afflicted enemies take damage equal to 10% of their maximum health every 5 seconds.

Notes

  • Host-type enemies will take burn and poison damage even if their skull is down, and all status effects can be applied by tears even if their skulls are down.

Burn

Passive Items that cause burning

Charm

Activated Items that cause charming

Passive Items that cause charming

Active Items that create charmed enemies

Passive Items that create charmed enemies

Notes

  • First stage of Ball of Bandages cannot charm enemies. See Ball of Bandages for details.
  • Charmed enemies will still target Isaac if they are the only enemy in the room.

Pills that cause charming

Pill Effect
Pheromones

Charms all enemies in the room for a short period of time.

Confusion

Passive Items that cause confusion

Trinkets that cause confusion

Fear

Activated Items that cause fear

Passive Items that cause fear

Petrification

Activated Items that petrify enemies

Passive Items that petrify enemies

Poison

Activated Items that poison enemies

Passive Items that poison enemies

Trinkets that grant poison tears

Pills that poison enemies

Pill Effect
Bad Gas

Isaac farts, poisoning enemies around him.

Slow

Activated Items that slow enemies

Passive Items that slow enemies

Notes

Shrink (except in Rebirth)

Passive Items that grant shrinking tears

Bleed (in Afterbirth † and Repentance)

Active items that inflict bleed

Passive Items that inflict bleed

Random

These items inflict random status effects on enemies.

Passive Items that inflict random effects

Tear Effects

Template:DisambigMsg Tear Effects modify the player character's primary weapon — tears. A few of the most common tear effects are listed below.

Homing Tears

Homing Tears slightly divert from their path and seek nearby enemies. The distance homing tears can travel is determined by the range stat.

Activated Items that grant homing tears

Passive Items that grant homing tears

Familiars that fire homing tears

Cards that grant homing tears

Piercing Tears

Piercing tears travel through enemies (but not obstacles) instead of breaking on impact with them. While they do not directly increase damage, piercing tears can allow the character to deal a greater amount of damage per second due to the multiple impact calculations on large bosses and the possibility to hit multiple enemies at once.
The downside of piercing tears is that they remove knockback.

Passive Items that grant piercing tears

Trinkets that grant piercing tears

Spectral Tears

Spectral tears travel through obstacles (but not enemies) instead of breaking on impact with them. Spectral tears can be used to safely dispatch most types of monsters from behind obstacles, or over them in combination with flying.

Passive Items that grant spectral tears

Familiars that fire spectral tears

Trinkets that grant spectral tears

Temporary Buffs

Temporary buffs are beneficial effects applied to the player character that will expire after a timed duration or on leaving a room, and are not tear effects.

Invulnerability

Invulnerability negates all types of damage for five seconds, including health loss from Blood Donation Machines and Devil Beggars, environmental hazards like spikes, and Curse Rooms doors and Sacrifice Rooms, but does not prevent heart container or Soul Heart loss from Health Down Pills, Devil Room deals, or spawning a baby.
While under the effects of invulnerability, the character has increased speed, loses the ability to shoot tears, flashes in multiple colors, and the music of the game speeds up. However, all invulnerability-granting items except for the Unicorn Stump also grant the character the ability to damage enemies by contact for the duration of the effect.

Activated Items that grant invulnerability

Passive Items that grant invulnerability

Trinkets that grant invulnerability

Cards that grant invulnerability

Shield

A shield negates all types of damage for a variable amount of time, depending on the item it's granted by, including health loss from Blood Donation Machines and Devil Beggars, environmental hazards like spikes, and Curse Rooms doors and Sacrifice Rooms, but does not prevent heart container or Soul Heart loss from Health Down Pills, Devil Room deals, or spawning a baby.
Unlike invulnerability, the shield does not prevent the character from attacking.

Activated Items that grant a shield

Passive Items that grant a shield

Runes that grant a shield


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