A Pound of Flesh is a passive item added in The Binding of Isaac: Repentance.
- Buying shop items for health does not prevent Angel Rooms from appearing.
- Taking a health consumable surrounded by spikes at half a heart will still result in Isaac's death.
- Immunity to spikes does not prevent damage when taking consumables in shops.
- When transformed into a ghost in Downpour II, shop consumables can't be taken even with Holy Mantle.
- The item is not available to Keeper and Tainted Keeper normally. If acquired through Spindown Dice, Death Certificate or such, it has no effect.
- Binge Eater: All shops become free stat-ups if the food item is chosen.
- Restock: The price never increases, staying at one red heart container/three soul hearts for each item, and one full heart of damage for pickups.
- Flat File: No effect. Spikes generated surrounding consumables will not be removed.
- Keeper's Box: Items and pickups generated outside Devil Rooms will cost health, but items generated inside Devil Rooms will cost coins.
- Keeper's Sack: Because shop items no longer cost coins, stat bonuses are no longer gained from buying shop items.
- The Lost: Only one item can be picked up from each shop; any other items will vanish. Consumables can be taken for free.
- However, multiple items can be bought from Devil Deals.
- With Restock, the Lost can buy items indefinitely.
- The Stairway: Affects Angel Shops the same way it does regular shops.
- Steam Sale: Devil Deals will have their price reduced. Shop items will cost the same amount of health.
- The name of this item is a reference to Shakespeare’s play The Merchant of Venice, where the Jewish moneylender Shylock asks the bankrupt Antonio for 'a pound of flesh' in payment for his debt.
- The name of this item matches the description of the Potato Peeler, which also references the play.