If this limit is reached Famine will move to try to position himself horizontally of Isaac so he can charge at him.
Any Pooters caught in Famine's charge will be killed.
When Famine takes a sufficient amount of damage, his body and horse explode and vanish while only his head remains.
Famine's head behaves similarly to a Maw, slowly moving towards Isaac, and occasionally stops to fire three projectiles in a spread at Isaac.
Famine deals a whole heart of contact damage in both phases and during his charge.
Champion Versions 
Blue: Charges more often and veers towards Isaac (similar to the Dark One). He can do this attack regardless of whether Isaac is to his sides or not. He will shoot six bullets in all directions instead of summoning Pooters. In Phase 2, he will spit out a cluster of bullets instead of a triple shot, similar to Monstro's attack, with a lower shot speed than his non-champion version. Will always drop a Soul Heart upon death.
Famine in his second phase.
Blue Champion Famine before Repentance.
Blue Champion Famine in his second phase before Repentance.