Items with this tag are familiars which are unique and cannot be duplicated by 
Box of Friends, and 
Soul of Lilith can grant them only once. Note that this does not prevent getting multiple copies of the items through duplication effects such as 
Diplopia.
Activated Collectibles[]
| Name | ID | Icon | Quote | Description | Quality |
|---|---|---|---|---|---|
| Stitches | 5.100.635 |  
|
Bait and switch | Passively spawns a familiar that moves in the direction Isaac shoots. On use, Isaac swaps places with the familiar. | 1 |
Passive Collectibles[]
| Name | ID | Icon | Quote | Description | Quality |
|---|---|---|---|---|---|
| Dead Cat | 5.100.81 | 
|
9 lives | Sets Isaac's Red Heart Containers to 1, but grants 9 extra lives. After dying, Isaac respawns with 1 Red Heart Container. | 3 |
| Isaac's Heart | 5.100.276 | 
|
Protect it | Isaac himself is now immune to all damage, and a heart familiar follows him. If the heart is hurt, Isaac is hurt. The heart charges up as Isaac shoots, firing 8 blood shots, knocking back enemies, and leaving a puddle of creep when released.
|
0 |
| Key Piece 1 | 5.100.238 | 
|
??? | Combined with  Key Piece 2, unlocks the golden gate in the starting room of  Chest and  Dark Room to fight  Mega Satan.
|
0 |
| Key Piece 2 | 5.100.239 | 
|
??? | Combined with  Key Piece 1, unlocks the golden gate in the starting room of Chest and Dark Room to fight Mega Satan.
|
0 |
| Milk! | 5.100.436 | 
|
Don't cry over it... | Spawns a glass familiar that spills on the floor upon taking damage.  After the milk spills, Isaac's tear delay is decreased by 2 for the current room. After the milk spills, Isaac's fire rate is increased by 1 for the current room.
|
1 |
| Blood Oath | 5.100.569 | 
|
Bleed me dry | Stabs Isaac at the beginning of each floor, draining his  Red Hearts. Increases damage and speed for the floor based on the amount drained.
|
2 |
| Knife Piece 1 | 5.100.626 | 
|
??? | Combined with  Knife Piece 2, creates a knife familiar that damages enemies and can open the door to the  Corpse.
|
0 |
| Knife Piece 2 | 5.100.627 | 
|
??? | Combined with  Knife Piece 1, creates a knife familiar that damages enemies and can open the door to the Corpse.
|
0 |
| Paschal Candle | 5.100.567 | 
|
Keep the flame burning | Gives Isaac a familiar that grants +0.4 Fire Rate for each consecutive room he's cleared without taking damage. The bonus stacks up to five times. | 3 |
| Vanishing Twin | 5.100.697 | 
|
He wants revenge | Spawns a familiar that becomes a clone of the floor's boss when entering the  Boss Room. Defeating it drops an extra item.
|
3 |
