Re-rolled items pick from the current room's item pool. if you have 99 coins it will create 3 x Quarters, 2 Dimes and 4 Pennies. The first and second familiars spawn after 15 hits, then 30 hits for the third and fourth, Cambion Conception cannot grant more than 4 familiars in total, UNLOCK: Unlock this item by beating ??? If you get hit in either of the other 2 states you will not be teleported, The Black Candle item will remove the Cursed Eye's teleportation effect, REPENTANCE - Burst now has 5 shots instead of 4, * secret room pool, item room, treasure room, item room pool, white, circle, pearl, When Isaac's tears hit anything, they leave a green toxic creep on the floor that damages enemies for 1 damage per tick, * item room, treasure room, item room pool, mystery liquid, grey, gray, green, A familar that is attached to Isaac, which will seek out and damage any enemies close by for 3 contact damage, * astrology, astronomy, item room, treasure room, item room pool, blue, glow, A familiar eye that follows Isaac and copies all his tear modifiers/effects, but shoots in random directions, Tears from this familiar deal 75% of Isaac's tear damage, UNLOCK: Unlock this item by beating Boss Rush with Cain, * item room, treasure room, item room pool, eyeball, white, circle, cataract, cains other eye, A familiar fly that can be moved around via use of the arrow keys dealing 2.5 contact damage per tick, similar to the Ludovico Technique's mechanic, UNLOCK: Unlock this item by beating Boss Rush with Blue Baby, * item room, treasure room, item room pool, blue fly, big fly, blue baby's only friend, fat, dead, ?? * shop room pool, shop item pool, the lost item pool, white, Causes Isaac's head to detach and orbit his body, blocking shots and dealing 7 contact damage per tick, BFFs will cause the Guillotine head to do double damage (14 damage per tick), Tears are still fired from Isaac's head but the hitbox remains around his body, UNLOCK: Unlock this item by beating the Isaac boss with Judas, * item room, treasure room, item room pool, chop, head, silver, metal, Gives Isaac an orbital ball of bandages that deals 7 contact damage per tick and blocks enemy shots, Collecting a second Ball of Bandages in the run turns the orbital into a pink head that shoots tears that deal 7 damage each and have a chance to charm enemies, Getting a third Ball of Bandages will transform the head into bandage girl which will chase enemies dealing 3.5 contact damage per tick while firing charm tears, A fourth Ball of Bandages will make the Bandage Girl bigger and stronger, making her deal 5.5 damage per tick instead, Any further Ball of Bandages will repeat the cycle, Increases the chance of champion enemies appearing by 15%, Doesn't affect the chance for champion bosses to spawn, * shop room pool, shop item pool, red, croissant, crescent, Bombs now become poop bombs, which deal 10 damage to all enemies in the room and daze them for a short period of time, Butt Bombs heal the poop bosses (Dingle, Dangle, Brownie) by 25% of their max HP, * boss rush pool, boss rush room, item room, treasure room, item room pool, poop, face, brown, If Isaac stands still and stops shooting for a second, he turns to stone, making him invincible until he moves/shoots again, Using bombs or your active item will remove the invicibility as well, This item is a reference to the Tanuki suit in Super Mario 3, * item room, treasure room, item room pool, raccoon, green, Spawns 2-5 friendly attack spiders every time you take damage, REPENTANCE - Buffed, used to spawn 1-2 spiders, * item room, treasure room, item room pool, the lost item pool, purple, blue, heart, cute spider baby, When Isaac dies, he has a 50% chance to resurrect with 1/2 a heart, * curse room pool, red chest pool, red chest item pool, devil pool, devil room pool, devil deal, This means if you roll into The Lost, changing back to another character will leave you with only 1/2 of a soul heart, Cannot turn you into a character that isn't unlocked yet, Also includes Lazarus II (Lazarus' revived form) and Dark Judas (effect of Judas' Shadow), It's also possible that this item will pick the same character, making it seem like nothing happened, *, grey, gray, black, remote, zapper, changer, building, A one time use item that when used will explode all objects (i.e. Can be used with Placebo to generate infinite batteries, Amnesia - Hides the floor map for the rest of the current floor (same as curse of the lost). or Satan), The Wafer becomes most effective in the Womb and beyond where enemies all deal a whole heart of damage, The Wafer causes the Sharp Plug item to only cost 1/2 a heart per use, Has no effect with the Keeper - there's no such thing as half a coin health point, * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, The spear cannot be thrown like Mom's Knife but deals damage while it is in contact with an enemy, *, grey, silver, sword, dagger, blade, knife, Tears now have a random chance to become sticky bombs, which will attach to enemies and explode after a few seconds, The bomb explosion deals your tear damage + 60, REPENTANCE - Explosivo tears now deal damage upon impact, When picked up, drops between 1-6 random pickups on the floor, Causes all item pedestals to be chosen from a random item pool instead of the pre-defined ones which normally exist, Fixed item drops won't be replaced - e.g. Each of them deal double your tear damage, similar to how standard blue flies work, War (Red) - Explodes when touching the enemy. Isaac's touch now petrifies enemies, turning them to gold for a few seconds. rocks, poop) in the room and deal 200 damage to all enemies in the current room, as well as every other room for the remainder of the floor, Also opens the boss rush door after Mom's Foot, blue womb door after Mom's Heart, secret rooms and super secret rooms, Like all single-use items, this item cannot be absorbed and used multiple times by the Void item, Entering a room with an angel statue will destroy it and automatically spawn one of the Angel mini bosses, REPENTANCE - This now blows up machines, beggars and fireplaces too, Upon use, this item will fart, pushing enemies away and causing a wave of rocks to spawn that spread outwards from Isaac in a circle, dealing 10 damage per hit to any enemies caught in it, Visually this item is very similar to Butter Bean, The rock waves can destroy destructible objects, e.g. This may cause you to skip floors where you left a trinket to spawn a Cracked Key. Explosions now only heal Isaac for half of a heart (previously healed a full heart), * item room, treasure room, item room pool, fire, heart, orange, burning, stannis, Makes tears break into 4 smaller tears on impact with anything, which deal half of your damage, * item room, treasure room, item room pool, brown, orange, headless, crickets body, When getting hit, this item has a chance to drop a soul heart or black heart, The chance to spawn a heart is affected by your luck stat and at +22 Luck it will activate 50% of the time, Enemies have a chance to drop half a red heart when killed, Item Pool: Item Room, Devil Room, Curse Room, Demon Beggar, * curse room pool, demon beggar pool, demon judgement pool, devil beggar pool devil pool, devil room pool, devil deal, item room, treasure room, item room pool, gimp mask, the lost item pool, grey, gray, black, An item only found in the secret room pool, * secret room pool, , the lost item pool, purple, black, grey, gray, flower, mtg magic the gathering, vintage, When you take damage, 1-2 coins will drop on the floor, When playing as the Keeper, this item drops 0-1 coins instead, * shop room pool, shop item pool, item room, treasure room, item room pool, pink, oink, Isaac's tears have a 15% chance of causing a fear effect, Feared enemies will run away from Isaac temporarily, The chance to fear enemies is affected by your luck stat and at +85 Luck it will activate every time, * dungeon room, blood challenge room, arena pool, item room, treasure room, item room pool, For Items it increases by 2 coins * the number of purchases. In the burst of tears is a kidney stone which deals a lot of damage, REPENTANCE - Kidney Stone is no longer a speed downgrade, UNLOCK: Unlock this item by beating Challenge #29 (Onan's Streak), Upon use, fires a huge Mega Satan laser for 15 seconds, dealing your tear damage * 5 per tick to anything in its path and pushing Isaac back by the force, The laser persists for the entire 15 seconds even between rooms and floors, This item appears in the Devil Room but is weighted to be about 5 times rarer than all other devil room items, UNLOCK: Unlock this item by beating Mega Satan with every character, *, red, grey, gray, brown, black, red, eyes, A crown appears above your head and while at exactly 1 full red heart of health, you gain a +1.5 Range Up, +2.0 Tears Up and +0.20 Shot Speed Up, Any time your health changes to be not exactly 1 red heart you lose the effect. as Bethany, Gives you a random syringe effect every room, The effect can be The Virus, Roid Rage, Speed Ball, Experimental Treatment, Synthoil, Euthanasia or Growth Hormones, Placed bombs explode after 0.66 seconds instead of the usual 1.5 seconds, This was called Exploded Firecracker in Antibirth, Farts produced by Isaac or familiars will be twice as large, Chance for enemies to burn when entering a room, The chance for this effect to activate is effected by your Luck stat, This includes key blocks and golden chests, Pickups left on current floor will appear in the starting room of the next floor, up to a maximum of 4 pickups, Active items will be rerolled upon using them, Using with Book of Virtues will only reroll the item the book is holding, Has no effect with Notched Axe due to how its durability works, UNLOCK: Unlock this trinket by defeating Mother as Eden, Random luck-based tear effects have an extra chance of occurring, The additional chance is effectively +3 Luck Up, Picking up red hearts now has a high chance to spawn 1-4 blue attack spiders, instead of giving you health back, This effect also works while fully healed, giving a guaranteed chance of getting spiders, While missing any red health the chance for spiders is less, Works for characters that don't use red health, which always gives you spiders, Hearts in Shops can be converted into spiders for free, Gives your familiars improved rate of fire while held, In Antibirth this trinket was called Song of the Siren, UNLOCK: Unlock this trinket by bombing the skull left by The Siren boss after her death, While held at the start of each floor, this trinket spawns four wisp familiar orbitals around Isaac, These wisps are the same as the ones created by the Book of Virtues item, UNLOCK: Unlock this trinket by beating the Boss Rush as Bethany, Your active item no longer gains charges, but battery drops become much more common, UNLOCK: Unlock this trinket by blowing up 10 Battery Beggars, Tears that miss enemies will redirect themselves and travel 90 degrees towards enemies, Tears must be roughly 2 tiles or closer to activate this effect, +10 Luck while held, but the trinket is destroyed when damage is taken, Blood donation machines, Curse Rooms and Sacrifice Rooms wont destroy it, Taking a hit and activating Holy Mantle won't destroy it, Can be dropped in order to avoid breaking it, This trinket is automatically given to you after clearing 3 bosses without taking damage, Treasure Rooms are replaced with Red Treasure Rooms, which contain a deal with the devil in place of a regular item pedestal, If an item room has not yet been entered, it can be transformed to either a regular or Red Treasure Room by picking up or dropping this trinket before entering, Does not affect the mirrored treasure room in Downpour II, UNLOCK: Unlock this trinket by defeating Mother as Azazel, Every time you pick up a coin, you have a small chance to gain 1 bar of charge on your active item, The chance for this effect to happen is 1/6th of the value of the coin picked up, Can only activate once per coin collected, In Antibirth this trinket was called Electric Penny, UNLOCK: Unlock this trinket by donating to a battery beggar until he pays out with an item 5 times, While held, your familiars will now orbit around Isaac instead of following behind him, Activates your active item just before damage would be taken, It doesn't activate for free - the charges are used up as normal if this effect activates. Corpse II drops same as Womb II, UNLOCK: Unlock this item by beating the Dark Room with Lazarus, * red chest pool, red chest item pool, shop room pool, shop item pool, blue box, pandoras box, When used, turns Isaac invincible and gains +0.28 speed for a 5 seconds, You cannot fire tears while the stump is active, Very similar to the My Little Unicorn item but does not deal contact damage, When used with Mom's Knife, you can still deal contact damage but will be unable to change the way the knife faces while the effect is active, * item room, treasure room, item room pool, white, lump, grey, gray, blob, While in a hostile room your speed raises at a rate of +0.065 per game tick, When you hit a speed stat of 2.0, Isaac will gain an invincibility effect for 5 seconds, increasing speed and allowing him to run into enemies to deal 40 contact damage per hit, The time it takes for the effect to activate becomes shorter with a higher base Speed stat, * astrology, astronomy, item room, treasure room, item room pool, blue, glow, circle, horns, Gives huge horns which stick out, allowing you to deal 18 contact damage if you hit something with enough speed, Will not deal contact damage unless you are moving fast enough (at least 0.8 speed), REPENTANCE - Aries now prevents receiving contact damage if ramming and killing enemies at full speed, * astrology, astronomy, item room, treasure room, item room pool, black, blue, cyan, glow, After getting hit once, you gain a damage reduction for the rest of the room similar to The Wafer item (-50% damage taken), * astrology, astronomy, item room, treasure room, item room pool, cyan, black, the lost item pool, item room pool, red, boom, tnt, * item room, treasure room, item room pool, wooden, cross, brown, Isaac can now hold two trinkets at the same time, Drops a random trinket on the floor when picked up, Allows you to pick up more trinkets while also holding The Tick, * shop room pool, shop item pool, purple, pink, bag, All of Isaac's bombs now leave a poison effect on any enemies within the blast radius, As well as dealing the standard 60 damage for a bomb, it will apply a Damage over Time effect that does 4 or 6 damage per tick, Has a chance to drop from the Super Sloth miniboss fight. Pretty Fly gives a Big Fan item rather than a fly orbital, UNLOCK: Unlock this by defeating Mega Satan as Tainted Eve, 1 Dot - Rerolls all of your items. red, bolt, cupid arrow, cupids arrow, When used, fires a high damage laser in a straight line across the room in a similar way to Brimstone, The laser deals damage equal to double your tear damage. You must make it back through the path solving a few bomb puzzles while avoiding her, to get back to the regular floor. Item Descriptions [1-10] CROWBAR "Create Your Own Entrance" Type: Active (3 Room Charge) Item Pool: Shop The achievement 'Sumptorium' is unlocked by defeating Delirium as Tainted Eve, When used, this will retreive the Tainted Forgotten's skeleton back to its owner's hands from any distance, Tainted Forgotten's Birthright effect. Displays information for all collectibles, trinkets, cards, runes, pills, horsepills and some rooms. The first piece drops by beating the first floor boss within 1 minute then bombing the shadow in the first room. Based on the Steam Workshop mod (originally called Water Balloon) created by HiHowAreYou, UNLOCK: Unlock this item by picking up the Blood Clot item 10 times, Isaac's tears slow down over time while moving across the room, and upon stopping completely or hitting an object will burst into 8 smaller tears which fire in all directions, This item will also allow you to 'feed' a tear with other tears. red, pink, broken, Better chance to win while gambling at the Shell Game and Fortune Telling Machine, Higher chance to get a random drop after clearing a room, REPENTANCE - Lucky Foot now guarantees positive pill effects, * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, item room, treasure room, item room pool, starting, pink, white, yellow, A target is placed on the floor which can be controlled. UNLOCK: Unlock this card by defeating Ultra Greedier mode as Tainted Bethany, Spawns a random pedestal item from the current room's item pool, In exchange, turns one heart container or 2 soul hearts into a broken heart. UNLOCK: Unlock this trinket by defeating Mother as Tainted Lost, Has a decent chance for Devil Deals to cost money instead of Health, The conversion rate is 1 heart container to 15 coins, Items can be on discount similar to the shop, making it 1 heart container = 7 coins instead, Can be dropped to disable this effect while in the room, UNLOCK: Unlock this trinket by defeating Isaac, ?? achievement (collect 50 items in a single run), X-Lax - Spawns a pool of slippery brown creep beneath Isaac, Experimental Pill - Increases one random stat and decreases another random stat. knife, red, silver, Gives a 33% chance of converting red heart drops into soul hearts. When used, the D12 re-rolls any rocks into another random type of object (e.g. See the dedicated Devil room page for more details, Reveals the entire map and shows the icons for every room which has one, This is completely useless if you currently have both the Treasure Map and The Compass, Doubles your current red hearts up to full health, * , the lost item pool, playing, card, white, red, When used, turns all pickups, chests and non-boss enemies in the room into Bombs, UNLOCK: Unlock this item by getting a 3 win streak, When used, turns all pickups, chests and non-boss enemies in the room into Coins, UNLOCK: Unlock this item by defeating The Lamb in under 20 minutes, When used, turns all pickups, chests and non-boss enemies in the room into Keys, UNLOCK: Unlock this item by defeating The Lamb without taking hearts, coins and bombs, When used, turns all pickups, chests and non-boss enemies in the room into Hearts, UNLOCK: Unlock this item by defeating any floor after Basement I with only half a heart of health (works as The Lost), Teleports you to the Devil Deal Room on the current floor, When used, instantly kills you and spawns 10 pickup on the floor, Each of the 10 things spawned can be any type of consumable or sometimes a pedestal item (up to a maximum of 3 pedestal items), Any pedestal item created by Suicide King will be related to the room where it was used, meaning that using it in the Angel room will spawn Angel room items, UNLOCK: Unlock this card by beating Challenge #7 (Suicide King), UNLOCK: Unlock this card by defeating Mega Satan as Tainted Magdalene, A card which can be thrown as a projectile directly infront of Isaac, instantly killing anything it hits, including most bosses, If thrown at a multi-phase boss with multiple forms such Satan, Mega Satan or Hush it will only kill that particular phase of the boss, If thrown at a multi-phase boss that works from a single health bar such as Isaac, ??? black, white, gray, grey, guppys tail, guppy tail, Upon use, the IV Bag takes half a red heart and spawns 1-3 coins (the same effect as a blood donation machine), Can drop from a blood donation machine after playing it, In the Womb and beyond this deals 1 full heart of damage, If no red hearts exist, other types of hearts are consumed instead, With the Keeper this is changed to spawning 0-1 coins per use instead, Item Pool: None (Blood donation machine only), Places a decoy on the floor which attracts enemies and explodes after a period of time, When it explodes, it deals 185 damage to everything in radius (Same damage as Mr Mega bombs), * item room, treasure room, item room pool, worst friend, dead, baby, pink, puppet, Bombs no longer automatically explode and will only do so when you activate the remote detonator, Can be used to detonate Dr. Fetus bombs early, * boss rush pool, boss rush room, shop room pool, shop item pool, item room, treasure room, The effect is shown visually in 3 stages with the character's belly getting larger each time until it finally gives birth to a familiar. They modify Isaac's Attributes, grant or modify Tear Effects, and much more. Without the long-range version, his mini-brimstone won't have enough length to use any homing items. Based on the Steam Workshop mod created by Strawrat and Aczom, UNLOCK: Unlock this item by dying to your own Ipecac explosion, Upon taking damage, you have a random chance to consume one of your currently held trinkets, gaining its effect permanently, Added as part of the Afterbirth+ Booster Pack #5. Following Isaac on his journey players will find bizarre treasures that change Isaac's form giving him super human abilities and enabling him to fight off droves of mysterious creatures, discover secrets and fight his way to safety. While in this form you can walk over enemies to mark them for death. - Spawns the last pill you used. grey, gray, Gives the player an invulnerability effect which lasts for a 10 seconds, Can be used to get free hits on the Blood Donation machines and Devil Beggars, * library pool, library room, book room pool, item room, treasure room, item room pool, white, pink, Allows Isaac to walk over gaps with a width of one tile, * shop room pool, shop item pool, the lost item pool, brown, wooden, Heals half a heart after every 13 enemies killed, Works with the Keeper for restoring coin HP, * item room, treasure room, item room pool, the lost item pool, black, grey, gray, bat, All spacebar items can now be 'overcharged', allowing them to be charged up twice instead of once, The extra charges appear in yellow on top of the normal green bars, This item works with self-recharging items, * shop room pool, shop item pool, pink, purple, 15c items are reduced to 7c. yellow, white, triangle, The three heart containers are pre-filled with red hearts, UNLOCK: Unlock this item by beating the Chest with The Lost, * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, real platinum god, the lost item pool, Enemy projectiles will now slowly curve away from Isaac and avoid hitting him, UNLOCK: Unlock this item by beating Dark Room with The Lost, * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, After entering a Planetarium the chance goes back to 1%. 's unique poops, Corn poop - Spawns a blue fly every 2 seconds, Flaming poop - Leaves behind fire that damages enemies, Black poop - Creates slowing black creep. white, grey, gray, A familiar that follows isaac around dropping white creep which slows down enemies that walk over it, Spawns 1-2 familiar blue spiders after every room, * item room, treasure room, item room pool, white, ball, dripping, A familiar that is controlled via the arrow keys and will automatically fire a laser if anything is in its line of sight, Robo-Baby 2.0's lasers deal 3.5 damage per hit, UNLOCK: Unlock this item by beating Challenge #16 (Computer Savvy), * robo baby 2.0, item room, treasure room, item room pool, red, eyes, grey, gray, robot, A familiar which follows Isaac and spawns a blue flies as you're firing tears, Rotten Baby can only create one fly at a time, meaning if he has created a fly he cannot make another until it is used, * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, dead, baby, The creep deals 2 damage per tick while enemies stand in it, Lazarus' revived form (Lazarus II) respawns with this item, * item room, treasure room, item room pool, blood drop, red blood, drip, Gives Isaac a guaranteed devil or angel room on every floor that they can appear, even if you have already beaten the boss and it didn't show up originally, Taking the Goat Head (or any other item) in a Devil Deal bars you from encountering Angel Rooms naturally. +4 damage from Curved Horn instead of 2, -4 Tear Delay from Cancer instead of 2), Item Pool: Shop, Greed Mode Shop, Mom's Chest, Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. purple, pink, circle, guppys collar, All of Isaac's tears now have a shield, allowing them to block an enemy projectile, If a tear blocks something, both Isaac's and the enemies tears are destroyed, * secret room pool, item room, treasure room, item room pool, white, lump, oval, When Isaac takes damage, he will start to leave a trail of blood creep behind him as he walks for the current room. 132. See next icon for Tainted character effects, Isaac - All new pedestal items cycle through two options. Poison deals 5 damage initially and then 3.5, UNLOCK: Unlock this item by beating Blue Womb (Hush) with Isaac, REPENTANCE - GB Bug is now a thrown projectile, activated by double tapping an attack button. It also doesn't do poison damage despite having the tagline 'toxic aura tears', * item room, treasure room, item room pool, brown, pink, purple, plant, Upon entering every 4th unexplored room, the Broken Watch will either slow down or speed up all enemies in the room, The slow effect is much more common than the speed up, * shop room pool, shop item pool, blue, grey, gray, smashed, clock, broken stop watch, broken stopwatch, A blue boomerang which can be thrown in a similar fashion to Mom's Knife, to stun any enemies it hits and deal damage, The damage dealt by the Boomerang is equal to double your tear damage, The boomerang can also be used to grab pickups and consumables from a distance, similar to the legend of zelda boomerang, The range of the boomerang is affected by range, with number one the distance is very short and makes the item a lot less effective, The Boomerang can be used to kill shopkeeper corpses, allowing you to farm their drops for coins, items, Steam Sale etc, REPENTANCE - Boomerang is now piercing, and has far less downtime between throwing it and being able to fire tears again, * shop room pool, shop item pool, crescent, moon, blue, grey, gray, * boss room pool, boss room item, grey, gray, punk, Decreases the size of Isaac, and your player hitbox, making you less likely to be hit, * boss room pool, boss room item, pro plus, tablet, medicine, white, * boss room pool, boss room item, grey, orange, family, picture, * boss room pool, boss room item, mushroom, fungi, fungus, Item Pool: Boss Room, Gold/Stone Chest, Key Beggar, * boss room pool, boss room item, brass, bronze, brown, gold, REPENTANCE - Also drops the Match Stick trinket, * boss room pool, boss room item, white, red, * boss room pool, boss room item, syringe, needle, grey, purple, pink, * boss room pool, boss room item, the lost item pool, dog, biscuit, brown, orange, A one-time use item which when used, will duplicate any pedestal items or consumables in the current room, If used in a shop, the duplicated items can be taken for free, If used on a trinket, another random trinket will spawn instead of a duplicate, If used in the Boss Rush, all the duplicates can be taken for free as well as one of the original items, If used in a Devil Room or Black Market, the duplicates can be taken for free, When used, copies the effect of the pill you are currently holding without consuming it, The charge time of this item depends on the quality of the pill you're holding, When used, has a 50% chance to drop one random type of coin (penny, nickel or dime), UNLOCK: Unlock this item by donating 33 coins to the Greed Donation Machine, UNLOCK: Keeper starts with this item after beating Isaac with Keeper, With this item, at the start of every room you will deal double your tear damage to the entire room in a poison effect, Enemies killed now also leave a pool of creep on the ground where they died.
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