Godhead: The tear keeps its damaging aura while attached to the enemy, the aura grows as the tear does until it explodes. The aura can damage only enemies other than the one the tear is stuck to, however.
Haemolacria: Main tears and burst tears can have the Explosivo effect. If a main tear has the Explosivo effect, it will burst with its explosion, the burst tears dealing damage based off the explosion damage.
Ipecac: Sticky shots will explode even if they fall to the floor after the initial target dies.
Lachryphagy: Explosivo tears can be fed and will burst into Explosivo tears; however, if normal tears are fed first, Explosivo fed to the normal tears will not give the tear the Explosivo effect.
Lost Contact: Tears that stick to enemies can still block/be destroyed by enemy shots.
Shielded Explosivo tears are no longer destroyed by shots while they're stuck to enemies. Up to the point that they explode, they block all enemy shots that come into contact with them, effectively cutting off an entire direction of attack (much like Dry/Fart Baby, but with a larger area of blockage and without forcing the player to waste time positioning). As such, this is an extremely powerful synergy between otherwise adequate items.
Mr. Mega: Increases the damage of Explosivo's explosions to 110.
Some Explosivo tears have the Holy Light effect applied to them. These tears spawn a beam of light after a few seconds of sticking to an enemy instead of exploding.
The Ludovico Technique: Not recommended. Tear will alternate between "normal" and black. If it touches an enemy, it will stick to it, grow in size, then explode. While the tear is stuck to an enemy, it stops doing damage and cannot be controlled, leaving the player helpless.