- Quadruples fire rate.
- x0.3 damage multiplier.
- Tears gain random worm trinket effects, as well as some item effects such as Rubber Cement, My Reflection and Tiny Planet.
- Azazel's Brimstone will fire as long as you hold down the fire button. It still shuffles through the worm effects rapidly.
- Brimstone / Monstro's Lung / Tech X: Fires automatically upon reaching full charge. Tech X overrides the worm trinket effects.
- Chocolate Milk: Tears will be automatically charged and shot.
- Cursed Eye: Adds an additional set of five shots periodically firing straight, as well as applying Cursed Eye's teleport whenever hit while firing.
- Tractor Beam: All tears now travel along the beam, improving overall accuracy and DPS.
- Soy Milk: Overridden by Almond Milk (no additional effect on tears or damage).
- The Ludovico Technique: The tear will rapidly teleport in a small area around it, making it difficult to aim.
|Bug!||Using Almond Milk in conjunction with Chocolate Milk and Neptunus at the same time will make it so Isaac is incapable of shooting tears.|
|The Binding of Isaac: Rebirth|
|Achievements||Attributes||Bosses||Cards and Runes||Challenges||Chapters|