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When used in a Boss Room, Devil Room, or Angel Room, Isaac is teleported to another room on the floor, and the room he was in does not reset. The room Isaac teleports to will respawn enemies if it had them.
When used in a Secret Room that previously contained Greed or Super Greed, the room becomes a regular Secret Room.
No longer rerolls the room into a regular Secret Room; instead respawns Greed or Super Greed (depending on which one was present before).
When used in a Shop that previously contained Greed or Super Greed, the Shop items will spawn. Rolling it again will cause new items to spawn on top of each other.
No longer spawns a regular Shop; instead Greed or Super Greed respawns.
When used in a room with a Champion enemy, the enemy will not respawn as a Champion.
Can be used to generate infinite rewards with both 9 Volt and AAA Battery and/or 4.5 Volt depending on the enemies in the room.
If Isaac only has either 9 Volt or AAA Battery, rewards can still be endlessly generated in a quadruple-sized room or an L-shaped room.
Enemies respawn exactly where they first spawned, even if that's where Isaac is standing, in which case Isaac will take damage immediately upon use of the D7. Right next to doors is usually a safe place to use it.
If used in the Mirrored World of Downpour or Dross II, the rooms will not only have their enemies respawn, but all the normal non-mirrored contents such as pickups are restored. Using it in the Shop causes it to be stocked normally, and additional uses will restock the Shop's contents, unlike normal Shops.
As Tainted Keeper, enemies respawned by the D7 will drop the same type of coins as they had before using the D7. This can be used to quickly generate money from enemies that dropped high-value coins or greatly increase Luck if an enemy dropped a Lucky Penny.
Enemies respawned by the D7 don't drop loot when killed if they were champions and don't grant score in daily runs.
Synergies
Book of Virtues: Spawns a grey six-sided die wisp on the middle ring. The wisps start gray; if the wisps get hit while they’re gray, they invoke the effect of the D7 in the current room and turn blue. Damage that turns the wisps from gray to blue is negated.
Interactions
Car Battery: Doubles the amount of enemies summoned, but does not give double rewards.
If used in a non-Boss Room containing Chubs, C.H.A.D.s, or Carrion Queens, each segment of the boss(es) will be revived as an entire clone, tripling their number.
Chests may be granted for clearing the room.
Mini-Bosses will always have the same drop.
D7 will not work when used in a 
Bug!
Dice 
The Binding of Isaac: Rebirth
