Items

Items are an integral part of the game-play of The Binding of Isaac: Rebirth. They modify Isaac's attributes, grant or modify tear effects, and much more.

Items are classified into several distinct types and groups. Some items are passive, which add an effect permanently to Isaac, while others only activate when used. The original The Binding of Isaac had 196 items. Rebirth has a total of 341 items. Afterbirth added 95 new items, for a total of 436 items. Afterbirth † added 111 new items, for a total of 547 items. Repentance added 169 new items, for a total of 716 items. An update for Repentance, V1.7.5, added 3 new items, for a total of 719 items. In Afterbirth † and prior, 13 items are considered special and will be less likely to appear if the player has already come across other special items. The Repentance expansion removed the Special Item mechanic, replacing it with the item weight and item quality mechanics.

For a list of which items can potentially appear in a given special room or under certain conditions, see item pool and Item Tags.

For the grids of items that appear in the stats menu, see Collection Page.

Not to be confused with cards and runes, pills, and trinkets.

Activated Collectibles

Unless the player has Schoolbag, only one activated item can be held at a time, with the old collectible being placed on a pedestal if a new activated item is picked up. Most activated items need to recharge before use, with the recharge bar filling either by clearing rooms or recharging over time. Other activated items do not have a charge bar, and, with a few exceptions (such as How to Jump), will instead either disappear after a single use or require resources such as coins or health. Some activated items will also grant passive effects as long as they are equipped.

In some special circumstances, activated items can be placed in the consumable slot instead of the standard activated item slot. This counts as both an extra activated item slot and an extra consumable slot, meaning that other activated items and consumables can be picked up as normal. Items in this slot are used with the consumable key, and can't be lost through any means (unless they're consumed like items from Dice Bag). Otherwise, they function the same as other activated items.

Notes

• Battery Bums and most Batteries charge the item(s) in the activated item slot first, then the item in the consumable slot. The exception to this is the Mega Battery, which recharges the items in both slots.
• Most trinkets that work with activated items (e.g. Vibrant Bulb, Panic Button, etc.) ignore the items in the consumable slot.

Name	ID	Icon	Quote	Description	Quality
A Pony	5.100.130		Flight + dash attack	Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge and dealing damage to enemies hit.	2
Anarchist Cookbook	5.100.65		Summon bombs	Spawns six Troll Bombs around the room.	1
Best Friend	5.100.136		Friends 'till the end	Spawns a decoy Isaac that explodes after 5 seconds. Enemies will always target the decoy and ignore Isaac.	1
Blank Card	5.100.286		Card mimic	Copies the effect of the card or rune currently held by Isaac. Copies the effect of the card currently held by Isaac. The charge time is based on the power of the card.	2
Blood Rights	5.100.186		Mass enemy damage at a cost	Upon use, takes a full heart of health and deals 40 damage to all enemies in the room.	0
Bob's Rotten Head	5.100.42		Reusable ranged bomb	Upon use, Isaac holds a poison bomb which can be thrown in the cardinal directions and explodes on impact.	1
Book of Revelations	5.100.78		Reusable soul protection	Increases the chance of a Devil Room / Angel Room appearing while held. On use, gives one Soul Heart, and replaces the boss of the current floor with a Harbinger if possible.	3
Book of Secrets	5.100.287		Tome of knowledge	Gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.	0
Book of Shadows	5.100.58		Temporary invincibility	Creates a protective shield, nullifying all types of damage in the current room for 10 seconds.	3
Box of Spiders	5.100.288		It's a box of spiders	Spawns 1-4 Blue Spiders that deal 2.5x damage to enemies. Spawns 4-8 Blue Spiders that deal 2x damage to enemies.	1
Breath of Life	5.100.326		Invincibility at a cost	Grants a brief moment of invincibility when the charge bar hits zero. If the spacebar is held for an additional second after hitting zero, Isaac will take damage.	0
Butter Bean	5.100.294		Reusable knock-back	Upon use, Isaac farts and knocks back nearby enemies and projectiles. Enemies pushed into walls or obstacles take 12 damage.	1
Converter	5.100.296		Convert your soul	Converts two Soul Hearts or Black Hearts into one filled Red Heart Container. Converts one Soul Heart or Black Heart into one filled Red Heart Container.	2
Crack the Sky	5.100.160		Holy white death	Summons 5 beams of light in random locations on the ground, dealing large amounts of damage to any enemies that touch them.	2
Crystal Ball	5.100.158		I see my future	Upon use, reveals the map (except the Super Secret Room) and drops a Soul Heart or random card/rune.	3
D10	5.100.285		Reroll enemies	Re-rolls all monsters in the room. Will attempt to re-roll monsters into ones with a similar amount of HP.	0
D100	5.100.283		REEROLLLLL!	Combines the effects of D4, The D6, and D20. Combines the effects of D1, D4, The D6, D7, D8, D10, D12, and D20.	3
D20	5.100.166		Reroll the basics	Rerolls all pickups in the current room.	2
D4	5.100.284		Reroll into something else	Rerolls all of Isaac's passive items.	3
Dad's Key	5.100.175		Opens all doors...	Upon activation, opens all doors in the current room in almost all circumstances, including doors which require a Key to open, entrances to Secret Rooms, and the door to Mega Satan.	1
Dead Sea Scrolls	5.100.124		It's a mystery	Triggers the effect of a random activated item from a list of possible options (not every activated item is included).	1
Deck of Cards	5.100.85		Reusable card generator	Gives Isaac a random card.	2
Doctor's Remote	5.100.47		Reusable air strike	Creates a crosshair on the ground that can be aimed with tear controls. A missile strikes the spot after 2 seconds, creating a heavy damage explosion.	1
Flush!	5.100.291		...	Turns all non-boss monsters in the room into poop. Instantly kills poop-themed bosses.	1
Forget Me Now	5.100.127		I don't remember...	On use, re-generates the current floor with a new layout. Isaac loses Forget Me Now, but keeps other items and consumables picked up on the original floor.	3
Guppy's Head	5.100.145		Reusable fly hive	Spawns 2-4 friendly Blue Flies that damage enemies.	3
Guppy's Paw	5.100.133		Soul converter	Upon use, converts one Red Heart Container into three Soul Hearts.	3
Head of Krampus	5.100.293		Krampus rage	Fires a powerful Brimstone beam in four cardinal directions, much like Krampus shoots. Fires a powerful Brimstone beam in four cardinal directions, much like Krampus shoots with a 50% chance to rotate all beams around Isaac 90 degrees.	2
How to Jump	5.100.282		It's time you learned how	Upon use, Isaac jumps in the direction he is currently moving, allowing travel over obstacles and enemies.	1
Isaac's Tears	5.100.323		Collected tears	Fires 8 tears around Isaac, which retain the damage, range, shot speed, and special tear effects. Each tear shot by Isaac increases item charge by one.	0
IV Bag	5.100.135		Portable blood bank	Upon use, Isaac loses half a heart of health (or a full heart in Chapter 4 onward) for a random amount of coins, similar to a Blood Donation Machine.	1
Kamikaze!	5.100.40		Become the bomb!	Creates an explosion around Isaac, damaging him and nearby enemies as well as destroying obstacles.	0
Lemon Mishap	5.100.56		Oops...	Creates a tiny pool of yellow creep, damaging enemies that cross it.	1
Magic Fingers	5.100.295		Pay to win	Uses 1 coin to deal a large amount of damage to all enemies in the room.	1
Mom's Bottle of Pills	5.100.102		Reusable pill generator	On use, gives Isaac a random pill.	1
Mom's Bra	5.100.39		Mass paralysis	Petrifies all enemies in the current room for around 4 seconds.	1
Mom's Pad	5.100.41		Mass fear	Inflicts fear to all enemies in the room for 5 seconds.	0
Monster Manual	5.100.123		Temporary buddy generator	Spawns a familiar from a specific selection for the current room. Spawns a familiar from a specific selection for the current floor.	1
Monstro's Tooth	5.100.86		Summon Monstro	A friendly Monstro jumps on a random enemy, dealing 120 area damage. Lands on Isaac if used in a room without enemies.	1
Mr. Boom	5.100.37		Reusable bomb buddy	Places a Mr. Mega bomb that deals 110 damage.	1
My Little Unicorn	5.100.77		Temporary badass	Gives invulnerability and +0.28 speed for six seconds, removing the ability to shoot tears and replacing it with the ability to deal 40 contact damage to enemies.	1
Notched Axe	5.100.147		Rocks don't stand a chance	Isaac destroys obstacles and opens Secret Rooms by walking into them, but cannot shoot or pick up items until it's cancelled. Toggles between tears and the pickaxe, which can be swung to attack and break obstacles. Using it depletes the charge, and it can't be used until next floor once the charge runs out.	1
Pandora's Box	5.100.297		??	Upon use, spawns specific pickups or items depending on the floor it is used on. Disappears after use.	2
Portable Slot	5.100.177		Gamble 24/7	Upon use, consumes 1 Penny and has a chance to drop a random pickup, like a Slot Machine.	0
Prayer Card	5.100.146		Reusable eternity	Gives an Eternal Heart per use.	3
Razor Blade	5.100.126		Feel my pain	On use, takes one heart of health and grants +1.2 damage for the current room.	0
Red Candle	5.100.289		Flame on	Throws out a flame that damages everything in its path, diminishing in size as it hits enemies or blocks shots.	2
Remote Detonator	5.100.137		Remote bomb detonation	Bombs placed by Isaac only explode when Remote Detonator is used. Gives 5 bombs.	1
Satanic Bible	5.100.292		Reusable evil... but at what cost?	Gives one Black Heart. Replaces the boss room item on the current floor with a Devil Deal.	4
Scissors	5.100.325		Lose your head	Turns Isaac's head into a stationary familiar for the current room which fires tears automatically. Isaac's body also shoots a controllable fountain of blood shots for the room.	1
Shoop Da Whoop!	5.100.49		BLLLARRRRGGG!	Fires a laser from Isaac's mouth.	2
Spider Butt	5.100.171		Mass enemy slowdown + damage	Deals 10 damage to all enemies in the room and slows them for 4 seconds. Enemies killed by Spider Butt spawn Blue Spiders.	1
Tammy's Head	5.100.38		Reusable tear burst	Shoots 10 tears in a circle around Isaac, which retain the Damage, Shot Speed, and special effects (such as poison) of Isaac's tears.	2
Telepathy for Dummies	5.100.192		Temporary psychic shot	Gives homing tears for the current room. Also gives +3 range.	1
Teleport!	5.100.44		Teleport!	Teleports Isaac to a random room on the current floor.	0
The Bean	5.100.111		Toot on command	Isaac farts, poisoning any enemy in close range.	0
The Bible	5.100.33		Temporary flight	On use, Isaac gains flight for the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but kills Isaac when used on Satan.	1
The Book of Belial	5.100.34		Temporary DMG up	+2 damage for the current room. Passively guarantees a Devil Room or Angel Room will appear while held. +2 damage for the current room. Passively increases the chance of finding a Devil Room or Angel Room while held.	2
The Book of Sin	5.100.97		Reusable item generator	Generates a random pickup, pill, card, or rune.	2
The Boomerang	5.100.338		It will never leave you	Throws a boomerang which retrieves pickups, as well as damages and petrifies enemies hit for 2 seconds.	2
The Candle	5.100.164		Reusable flames	Throws out a flame that damages everything in its path, diminishing in size as it travels.	2
The D6	5.100.105		Reroll your destiny	Re-rolls all items in the current room into other items, depending on the current room's Item Pool.	4
The Gamekid	5.100.93		Temporary Man-Pac	Turns Isaac into a into a Pac-Man-like creature for 6 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing a Half Red Heart for every two enemies killed.	2
The Hourglass	5.100.66		Temporary enemy slowdown	All enemies in the room are slowed for 8 seconds.	1
The Jar	5.100.290		Save your life	When at full health, up to 4 extra Red Hearts can be stored in The Jar. Activating drops the stored hearts on the ground.	0
The Nail	5.100.83		Temporary demon form	Gives one Soul Heart. For the current room; +0.7 damage, -0.18 speed, Isaac breaks rocks and deals contact damage. Gives half a Black Heart. For the current room; +2 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.	3
The Necronomicon	5.100.35		Mass room damage	Deals 40 damage to every enemy in the room.	1
The Pinking Shears	5.100.107		Cut and run	Gives flight for the current room, while turning Isaac's body into a fast, high damage familiar.	2
The Poop	5.100.36		Plop!	Spawns a pile of poop where Isaac is standing and knocks back nearby enemies. May yield pickups like regular poop.	0
Undefined	5.100.324		Undefined	Teleports Isaac to the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.	2
Unicorn Stump	5.100.298		You feel stumped	Gives invulnerability and increased speed for five seconds, but removes the ability to shoot tears.	1
We Need to Go Deeper!	5.100.84		Reusable level skip	Creates a trapdoor to go to the next floor.	2
White Pony	5.100.181		Flight + holy death	Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge while also creating damaging beams of light.	2
Yum Heart	5.100.45		Reusable regeneration	Restores one full Red Heart.	1
Box of Friends	5.100.357		Double your friends	Duplicates all of Isaac's familiars for the current room. If Isaac has no familiars, spawns a Demon Baby for the room instead.	1
D12	5.100.386		Rerolls rocks	Re-rolls all Rocks and Metal Blocks in the current room into other random objects, such as Bomb Rocks, TNT, or Poops. Poops and TNT cannot be rerolled into other objects with this item.	1
D7	5.100.437		Roll again	Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.	1
D8	5.100.406		Reroll stats	Re-rolls Isaac's damage, tears, range, and speed.	2
Diplopia	5.100.347		Double item vision	Duplicates all pickups and item pedestals in the room.	3
Friendly Ball	5.100.382		Gotta fetch 'em all!	Throwing the ball at a monster instantly kills and captures it. The captured enemy can later be released and will be friendly, fighting for Isaac and persisting between rooms.	2
Glass Cannon	5.100.352		Be gentle...	Fires a high-damage piercing spectral tear, but lowers Isaac's health to half a heart. Fires a high-damage piercing spectral tear. If Isaac takes damage while holding this, he takes extra damage and it becomes Broken Glass Cannon.	1
Glowing Hour Glass	5.100.422		Turn back time	Rewinds time, putting Isaac back in the previous room and undoing anything that happened in the current room.	3
Jar of Flies	5.100.434		Bug catcher	Killing an enemy adds a fly to the jar, up to a maximum of 20. On use, releases Blue Flies equal to the number of flies in the jar.	2
Kidney Bean	5.100.421		Love toots!	Isaac farts, charming all nearby enemies.	1
Mega Bean	5.100.351		Giga fart!	Petrifies all enemies in the current room for a couple of seconds, poisons any enemies near Isaac, and sends a rock wave across the room in the direction Isaac is facing.	1
Mega Blast	5.100.441		Laser breath	Upon use, Isaac fires a laser similar to the one used by Mega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active.	4
Mine Crafter	5.100.427		Booom!	Places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used again in the same room while the previous TNT barrel is still intact, remotely detonates the TNT.	1
Mom's Box	5.100.439		What's inside?	Increases luck by 1 and doubles the effects of trinkets while held. When used, drops a random trinket on the ground.	3
Placebo	5.100.348		Pill mimic	When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.	2
Tear Detonator	5.100.383		Remote tear detonation!	When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.	1
Teleport 2.0	5.100.419		I-Teleport!	Teleports Isaac to a room that has not been explored yet. Normal rooms are prioritized over special rooms, and common special rooms take priority over rarer ones.	3
Ventricle Razor	5.100.396		Short cutter	Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.	1
Wooden Nickel	5.100.349		Flip a coin	When used, has a 50% chance to drop a random coin.	1
Black Hole	5.100.512		Nothing can escape	Throws a black hole on the ground which sucks in and damages enemies.	1
Book of the Dead	5.100.545		Rise from the grave	Upon use, creates a friendly Bony, Black Bony, or an orbital bone for each enemy killed in the current room. Can also create a friendly Bone Fly or Revenant.	3
Broken Shovel	5.100.550		It feels cursed	While held, causes 1 or more copies of Mom's Foot to stomp on Isaac. One of two parts necessary to create Mom's Shovel.	4
Brown Nugget	5.100.504		Friendly fly	Spawns a stationary fly turret that fires tears at nearby enemies.	0
Clicker	5.100.482		Change	Transforms Isaac into a random character and removes the last item collected.	0
Compost	5.100.480		Gain more friends!	Doubles Isaac's Blue Flies and Blue Spiders, or spawns one if Isaac has none. Converts pickups in the current room into Blue Flies or Blue Spiders.	2
Coupon	5.100.521		Allow 6 weeks for delivery	While held, guarantees one item in every Shop will be on sale. On use, makes a random item in the current room free.	2
Crooked Penny	5.100.485		50/50	Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.	1
D Infinity	5.100.489		Reroll forever	Grants a random die item that changes each use. Acts as any die item, and can by cycled by pressing the drop key.	4
D1	5.100.476		What will it be?	Duplicates a random pickup in the room. The new pickup may be different than the original (i.e. a different card, etc).	3
Dataminer	5.100.481		109	Displaces enemy sprites for the current room, randomly increases one stat and decreases another.	0
Delirious	5.100.510		Unleash the power!	Spawns Delirium as a random friendly boss that fights for Isaac.	1
Dull Razor	5.100.486		I feel numb...	Hurts Isaac without depleting health, activating any items that trigger upon taking damage.	1
Eden's Soul	5.100.490		...	Spawns two item pedestals then is consumed. Begins with no charges.	3
Mama Mega!	5.100.483		BOOOOOOOOOM!	Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens the doors to the floor's Secret Rooms and Super Secret Rooms.	3
Metronome	5.100.488		Waggles a finger	Grants a random item effect for the current room.	1
Mom's Shovel	5.100.552		Lost but not forgotten	Creates a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in Dark Room.	4
Moving Box	5.100.523		Pack and unpack	If the box is empty, picks up all items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room.	1
Mr. ME!	5.100.527		Caaan do!	Summons a controllable ghost that can perform various tasks depending on what it targets.	3
Mystery Gift	5.100.515		Wrapped up nice for you!	Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead.	3
Pause	5.100.478		Stop!	Freezes all enemies until a fire button is pressed.	1
Plan C	5.100.475		My last resort	Kills all enemies in the room, then kills Isaac three seconds later.	0
Potato Peeler	5.100.487		A pound of flesh	Removes a Heart Container, increases damage and range, and grants a Cube of Meat.	2
Sacrificial Altar	5.100.536		He demands a sacrifice	Sacrifices up to 2 familiars and spawns an item from the Devil Room pool for each familiar sacrificed. Converts all friendly spiders and flies into coins.	2
Sharp Straw	5.100.507		More blood!	Damages all enemies in the room. Has a chance to drop a half red heart or half soul heart if an enemy is hit.	2
Smelter	5.100.479		Trinket melter!	Consumes Isaac's currently held trinket and applies its effect permanently.	3
Sprinkler	5.100.516		Sprinkles.	Upon use, creates a stationary sprinkler that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects.	2
Telekinesis	5.100.522		Power of the mind	Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears.	1
Void	5.100.477		Consume	Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant random stat upgrades.	4
Wait What?	5.100.484		I can't believe it's not butter bean!	Isaac farts, sending out rock waves.	1
Abyss	5.100.706		Come forth from the depths	Destroys all items in the room and gives Isaac a unique locust familiar for each item destroyed. Some items generate locusts with special effects.	4
Alabaster Box	5.100.585		A sacred offering	Spawns three Soul Hearts and two Angel Room items and is consumed. Starts with no charges, and can only be charged by picking up 6 Soul Hearts.	2
Anima Sola	5.100.722		Repent	Chains down the nearest enemy for 5 seconds, preventing them from acting.	3
Bag of Crafting	5.100.710		Make your destiny	Collects and holds up to 8 pickups, which can then be used to craft an item. The power level of the item is based on the quality of pickups used.	4
Berserk!	5.100.704		Rip and tear	Causes Isaac to go berserk for 5 seconds, greatly increasing his speed, tears, and damage, but restricting him to using a melee weapon instead of his tears. This item charges by dealing damage to enemies instead of clearing rooms.	3
Book of Virtues	5.100.584		Spiritual companionship	On use, spawns a destroyable orbiting Wisp familiar that fires tears and deals contact damage. Also acts as a passive item that causes other active items to spawn themed Wisps.	3
Broken Glass Cannon	5.100.474		You broke it!	Begins with no charges and turns into Glass Cannon when used. Only acquired by taking damage while holding Glass Cannon.	0
Clear Rune	5.100.263		Rune mimic	Has the same effect as the rune or soul stone currently held by Isaac.	2
Damocles	5.100.577		A king's fortune... but at what cost?	Spawns a sword above Isaac's head, which doubles all item pedestals. After Isaac takes damage, the sword can randomly fall at any point, instantly killing him.	2
Dark Arts	5.100.705		One with the shadows	Briefly grants +1 speed and makes Isaac invulnerable and intangible. When the effect ends, destroys all projectiles and damages all enemies Isaac ran through.	3
Death Certificate	5.100.628		Where am I?	Takes Isaac to an abandoned and expanded version of Home, which has one copy of every item in the game. After taking an item, Isaac returns to the room he used Death Certificate in.	4
Decap Attack	5.100.729		Chuck away!	Throws Isaac's head, which is still able to fire tears at the spot it lands. Reactivating the item or stepping on the head reattaches it.	2
Eraser	5.100.638		Erase thy enemy	Throws an eraser that instantly kills the first monster it hits, and prevents that monster from spawning for the rest of the run. Can only be used once per floor.	2
Esau Jr.	5.100.703		Lost brother	Swaps between the current character and Esau Jr., who has +2 flat damage and flight. Characters have independent items and health. Dying as either character ends the run.	2
Eternal D6	5.100.609		???	Rerolls all items in the room. Each item has a 30% chance to disappear instead.	3
Everything Jar	5.100.720		Anything is possible	Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects.	2
Flip	5.100.711		Twist of fate	Item pedestals have a second uninteractable "ghostly" item behind them. Activating will flip the real and ghostly items around. If playing as Tainted Lazarus, also flips between them and Dead Tainted Lazarus.	4
Fortune Cookie	5.100.557		Reusable fortunes	Gives Isaac a fortune, Soul Heart, Card, Rune, or trinket, similar to a Fortune Telling Machine. Fortunes are much more likely to be given than anything else.	2
Free Lemonade	5.100.578		Party time!	Creates a large pool of yellow creep beneath Isaac.	1
Friend Finder	5.100.687		Best friends forever!	Spawns a random friendly monster that mimics Isaac's movements and attacks.	3
Gello	5.100.728		Demonic gestation	Spawns a demon familiar that's attached to Isaac and moves and fires in the direction Isaac shoots, using Isaac's damage, tears, range, shot speed, and special tear effects.	3
Genesis	5.100.622		In the beginning	Removes all of Isaac's items and pickups and takes him to a unique Bedroom with some pickups and Chests and a trapdoor to the next floor. For every item Isaac lost, he gets to take an item from a set of three.	2
Golden Razor	5.100.555		Pain from gain	Spends five coins to increase Isaac's damage by 1.2 for the current room.	1
Hold	5.100.715		Saved for later	Exclusive to Tainted ???. Allows him to save one poop bomb for later, allowing him to gather more over time.	0
Jar of Wisps	5.100.685		Your faith grows	Spawns random wisps that shoot various tears, block shots, and deal contact damage. The number of wisps spawned increases every time the jar is used.	2
Keeper's Box	5.100.719		Portable shop	Spawns a random shop item or pickup which can be bought for its normal price.	2
Larynx	5.100.611		Hear my pain	Isaac shouts, damaging and pushing away nearby enemies. The shout gets stronger the more charges the item has. Can also be charged by taking damage.	2
Lemegeton	5.100.712		Item summoner	Spawns a wisp representing a random passive item, which orbits Isaac but can be destroyed. While the wisp is alive, Isaac gains that item's effects. Generation uses the current room's item pool 25% of the time, otherwise a random pool.	3
Magic Skin	5.100.642		All your desires fulfilled	Consumes one heart container or two soul hearts to spawn an item and give Isaac a broken heart container that can never be filled. If Magic Skin isn't being held after being used, it is very likely to replace any future items.	2
Meat Cleaver	5.100.631		Slice but no dice	Splits all enemies in the room into two smaller versions of themselves with much less health.	1
Mega Mush	5.100.625		I'm a big boy now!	Gigantifies Isaac for 30 seconds, increasing damage and range while lowering tears, granting invulnerability, and allowing Isaac to crush enemies and obstacles he walks on. The effect persists between rooms.	4
Mom's Bracelet	5.100.604		Mother's strength	Lets Isaac pick up and throw rocks, TNT, poops, friendly Dips, Bombs, and other obstacles.	2
Plum Flute	5.100.650		Play time!	Summons the boss Baby Plum to fight for Isaac in the current room.	2
R Key	5.100.636		Time to start over	Brings Isaac back to the first floor of a new run, retaining all of his items.	4
Recall	5.100.714		Come back	Retrieves the Forgotten's body from any distance. Only available as the Birthright effect for Tainted Forgotten.	0
Red Key	5.100.580		Explore the other side	Creates a Red Room adjacent to a viable wall, indicated by the outline of a door. These rooms have a 10% chance to be a special room.	3
Sharp Key	5.100.623		Open your enemies	Adds 5 keys on pickup. Allows Isaac to throw his keys to deal damage to enemies, destroy obstacles, and open doors.	1
Spin to Win	5.100.655		Let it rip!	When used, gives Isaac +0.5 speed and greatly increases the rotation speed of Isaac's orbitals for 3 seconds. Gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage to enemies while held.	1
Spindown Dice	5.100.723		-1	Transforms all items in the room by decreasing their internal ID number.	4
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
Sulfur	5.100.556		Temporary demon form	Grants Brimstone for the current room.	2
Sumptorium	5.100.713		Blood to blood	Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Tainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health.	3
Suplex!	5.100.709		Angel breaker	Isaac dashes forward and picks up the first enemy hit. After a moment, he slams them into the ground to deal damage and create a circular rock wave.	3
The Scooper	5.100.605		Plop!	Summons a Peeper familiar for the current room, which leaves a trail of red creep.	0
Urn of Souls	5.100.640		Unleash their sorrow	Spews a stream of damaging flame. Gains Soul Charges each time an enemy dies, which are used to fuel the urn.	3
Vade Retro	5.100.653		Begone!	While held, enemies leave behind ghosts on death. Using the item causes the ghosts to explode, dealing damage to nearby enemies. Stronger enemies leave bigger ghosts. Ghost enemies and bosses are also destroyed if this is used while they have less than half HP.	3
Wavy Cap	5.100.582		Tears up. A mind changing experience!	Increases tears, decreases speed, and distorts the screen. All effects become more pronounced with repeated use, and wear off by clearing rooms.	1
Yuck Heart	5.100.639		Gross!	Gives Isaac a Rotten Heart.	2

Passive Collectibles

An unlimited amount of passive collectibles can be held at a time, and the effects they grant are permanent. Their effects are vast and diverse, from simple stat and health increases to completely changing the way Isaac's tears behave.

Name	ID	Icon	Quote	Description	Quality
???'s Only Friend	5.100.320		Controlled friend	Spawns a controllable familiar that deals 37.5 damage per second on touch. It can be moved using the shooting directional keys	2
<3	5.100.15		HP up	Grants Isaac one Red Heart container and fully restores Isaac's health.	2
1up!	5.100.11		Extra life	Gives Isaac an extra life. Upon death, he will respawn in the most recent non-hostile room with full health, after which 1up! will disappear.	2
20/20	5.100.245		Double shot	Isaac fires two tears at once, one from each eye. 0.75x damage multiplier.	4
3 Dollar Bill	5.100.191		Rainbow tears	Gives Isaac a random tear effect every room. Gives Isaac a random tear effect every few seconds.	2
9 Volt	5.100.116		Quicker charge	Reduces the charge of any activated item by 1. Any 1 charge items instead have timed recharges.	2
A Dollar	5.100.18		$$$	Gives Isaac 100 pennies.	3
A Lump of Coal	5.100.132		My Xmas present	The more distance tears travel, the more damage they will do.	3
A Quarter	5.100.74		+25 coins	Gives Isaac 25 coins.	1
A Snack	5.100.346		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Abaddon	5.100.230		Evil + DMG up + fear shot	+1.5 damage, +0.2 speed. Removes all Red Heart containers, grants six Black Hearts, and adds a chance to shoot fear tears. +1.5 damage, +0.2 speed. Grants two Black Hearts, converts all Red Heart Containers into Black Hearts, and adds a chance to shoot fear tears.	3
Abel	5.100.188		Mirrored buddy	Spawns a familiar that mirrors Isaac's movements and shoots in the opposite direction.	0
Anemic	5.100.214		Toxic blood	+5 +1.5 range. After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room.	1
Ankh	5.100.161		Eternal life?	Upon death, Isaac will respawn as ??? in the most recent non-hostile room, with 3 Soul Hearts.	1
Anti-Gravity	5.100.222		Anti-gravity tears + tears up	-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.	2
Aquarius	5.100.308		Trail of tears	A trail of blue creep is left behind Isaac, which damages enemies. The creep inherits most of Isaac's tear effects, like homing, etc.	1
Aries	5.100.300		Ramming speed	+0.25 Speed. Running into enemies while at a high speed will deal damage. Prevents Isaac from taking contact damage while moving at high speed.	2
Ball of Bandages	5.100.207		Gotta lick 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot Charm tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Ball of Tar	5.100.231		Sticky feet...	Adds a chance to shoot slowing tears. Isaac leaves a trail of slowing creep behind as he moves, impeding enemies' speed.	2
BBF	5.100.272		Big Beautiful Fly	Spawns a familiar that flies around the room in a zig-zag pattern and explodes on contact with an enemy. Respawns after ten seconds.	1
Best Bud	5.100.274		Sworn protector	When hit, spawns a quickly orbiting attack fly similar to Forever Alone for the current room that deals high damage.	0
BFFS!	5.100.247		Your friends rule!	Increases the size and effectiveness of most familiars.	2
Big Fan	5.100.279		Fat protector	Spawns a large orbital familiar that blocks enemy shots and deals 30 damage per second to enemies.	2
Black Candle	5.100.260		Curse immunity + evil up	Prevents curses. Grants one Black Heart. Increases the chance for a Devil or Angel Room to appear.	3
Black Lotus	5.100.226		HP up x3!	Grants one Red Heart, one Soul Heart, and one Black Heart.	2
Blood Bag	5.100.119		HP up	Grants one Red Heart container, restores 5 Red Hearts, and increases speed by 0.3.	2
Blood Clot	5.100.254		DMG + range up	Tears fired from the left eye have +1 flat damage, +5 range, and +0.5 tear height.	2
Blood of the Martyr	5.100.7		DMG up	Increases damage by 1, and turns Isaac's tears into blood tears.	3
Bloody Lust	5.100.157		RAGE!	Increases Isaac's damage whenever he takes damage, up to six times. The bonus resets when entering a new floor.	3
Blue Cap	5.100.342		HP + tears up + shot speed down	Gives one full Red Heart container, +0.7 tears, and -0.16 shot speed. Heals 2 additional hearts of health.	3
Blue Map	5.100.246		Secrets	Reveals the locations of Secret Rooms and Super Secret Rooms on the map.	2
Bob's Brain	5.100.273		Explosive thoughts	Spawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.	1
Bob's Curse	5.100.140		+5 poison bombs	Gives 5 bombs and grants Isaac's bombs a poison effect. Gives Isaac immunity to poison.	1
Bobby-Bomb	5.100.125		Homing bombs!	+5 bombs. Bombs gain a homing effect, slowly moving towards the nearest enemy.	2
Bogo Bombs	5.100.250		1+1 BOOM!	All normal Bombs become Double Bombs.	1
Bomb Bag	5.100.131		Gives bombs	Spawns a familiar that drops a Bomb every 3 rooms.	2
Boom!	5.100.19		10 bombs	Grants 10 bombs.	0
Box	5.100.198		Stuff	Spawns various pickups: 1 coin, 1 key, 1 bomb, 1 Red Heart, 1 card/rune, 1 pill and 1 trinket.	1
Breakfast	5.100.25		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Brimstone	5.100.118		Blood laser barrage	Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.	4
Broken Watch	5.100.337		I think it's broken	Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.	1
Brother Bobby	5.100.8		Friends 'till the end	A familiar that follows Isaac around shooting normal tears.	1
Bucket of Lard	5.100.129		HP up	Grants two empty Red Heart containers, heals Isaac by half a Red Heart, -0.2 speed. Grants two Red Heart containers, heals Isaac by half a Red Heart, -0.2 speed.	1
Bum Friend	5.100.144		He's greedy	Spawns a familiar that picks up s for himself, giving random pickups in return. Does not spawn collectibles.	0
Butt Bombs	5.100.209		Toxic blast +5 bombs	+5 bombs. Bombs now cloud up the screen, briefly damaging and confusing all enemies.	2
Caffeine Pill	5.100.340		Speed up + size down	Grants +0.3 speed, reduces character size, and gives a random pill.	1
Cain's Other Eye	5.100.319		Near-sighted friend	Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.	0
Cancer	5.100.301		HP up + you feel protected	Adds 3 Soul Hearts. Grants The Wafer effect for the current room after taking damage.	3
Capricorn	5.100.307		All stats up	Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +1.5 Range, and -1.0 Tear Delay, and gives 1 Bomb, Coin, and Key. Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +0.75 Range, and -1.0 Tear Delay, and gives 1 Bomb, Coin, and Key.	3
Cat-O-Nine-Tails	5.100.165		Shot speed + damage up	+1 damage, +0.23 shot speed.	3
Celtic Cross	5.100.162		Blessing of protection	Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.	1
Ceremonial Robes	5.100.216		DMG + evil up	Grants 3 Black Hearts, and +1 damage.	3
Champion Belt	5.100.208		DMG + challenge up	Increases damage, but also increases the chance of champion enemies appearing.	3
Charm of the Vampire	5.100.62		Kills heal	Heals Isaac for a Half Red Heart for every 13 enemies killed. +0.3 damage.	1
Chemical Peel	5.100.154		DMG up	Tears fired from the left eye have +2 flat damage.	2
Chocolate Milk	5.100.69		Charge shots	Grants charged tears that deal greater damage when fully charged.	3
Contract From Below	5.100.241		Wealth... but at what cost?	Doubles the number of most room clear awards, but reduces the overall chance of getting one by 1/3.	3
Cricket's Body	5.100.224		Bursting shots + tears up	Grants -1 tear delay and reduces range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose range and damage scale with Isaac's.	3
Cricket's Head	5.100.4		DMG up	Increases Damage by 0.5, and increases damage multiplier by x1.5.	4
Cube of Meat	5.100.73		Gotta meat 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Cupid's Arrow	5.100.48		Piercing shots	Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.	3
Cursed Eye	5.100.316		Cursed charge shot	Grants charged tears that can be fired in a tight burst. Getting hit while charging will teleport Isaac to another room.	0
Daddy Longlegs	5.100.170		Daddy's love	Daddy Long Legs' shadow follows Isaac and occasionally stomps enemies for 40 damage total.	3
Dark Bum	5.100.278		He wants to take your life	Spawns a familiar that follows Isaac around and collects Red Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward.	3
Dark Matter	5.100.259		DMG up + fear shot	+1 damage, adds a chance to shoot fear tears.	3
Dead Bird	5.100.117		Protective buddy	After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~5 damage per second.	0
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
Dead Dove	5.100.185		Flight + spectral tears	Grants spectral tears and flight.	3
Dead Onion	5.100.336		Toxic aura tears	Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.	3
Death's Touch	5.100.237		Piercing shots + DMG up	+1.5 damage, -0.3 tears. Tears are replaced with large piercing scythes.	3
Demon Baby	5.100.113		Auto-turret friend	Spawns a familiar that follows Isaac and automatically fires at enemies in its reach.	2
Dessert	5.100.24		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Dinner	5.100.23		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Distant Admiration	5.100.57		Attack fly	Spawns an attack fly that circles further out than Halo of Flies, but closer than Forever Alone, dealing 75 damage per second.	2
Dr. Fetus	5.100.52		???	Tears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.	4
Dry Baby	5.100.265		Immortal friend	Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.	3
E. Coli	5.100.236		Turdy touch	Enemies that touch Isaac are transformed into poop.	1
Epic Fetus	5.100.168		On-demand air strike	Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.	4
Eve's Mascara	5.100.310		DMG up, tears + shot speed down	Doubles damage, halves tears stat, and greatly reduces shot speed.	2
Experimental Treatment	5.100.240		Some stats up, some stats down	Randomly increases and decreases some of Isaac's stats. Increases four random stats and decreases the other two.	1
Fanny Pack	5.100.204		Filled with goodies	Has a chance to drop a random pickup when Isaac takes damage.	1
Fate	5.100.179		Flight eternal	Grants flight and one Eternal Heart.	3
Fire Mind	5.100.257		Flaming tears	Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.	2
Forever Alone	5.100.128		Attack fly	Spawns an attack fly that orbits a long distance from Isaac, dealing 30 damage per second.	1
Gemini	5.100.318		Conjoined friend	Spawns a conjoined familiar which chases enemies close to Isaac, dealing ~8 damage per second.	1
Ghost Baby	5.100.163		Spectral buddy	Spawns a familiar that follows Isaac around and fires spectral tears.	1
Gimpy	5.100.225		Sweet suffering	Gives chance of spawning a Soul Heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.	2
Gnawed Leaf	5.100.210		Unbreakable	After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.	1
Goat Head	5.100.215		He accepts your offering	A Devil Room / Angel Room will always spawn after every boss fight, excluding the first floor and floors after Chapter 4.	3
Godhead	5.100.331		God tears	Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears -0.3 Shot Speed, +0.8 Tear Height, and +1.2 Range. Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears -0.3 Shot Speed, and +0.8 Tear Height.	4
Growth Hormones	5.100.70		Speed + DMG up	+1 damage, +0.4 speed. +1 damage, +0.2 speed.	3
Guardian Angel	5.100.112		Extra protection	Spawns an orbital familiar that blocks enemy shots, deals 105 damage per second to enemies, and increases the speed of all orbital familiars.	2
Guillotine	5.100.206		DMG + tears up. An out-of-body experience!	Isaac's head is removed from his body and floats around him as an orbital. Gives +1 damage and grants -1 tear delay.	2
Guppy's Collar	5.100.212		Eternal life?	Grants a permanent 50% chance to respawn with 1/2 of a Red Heart after death.	2
Guppy's Hair Ball	5.100.187		Swing it	Spawns a familiar that loosely follows behind Isaac, which blocks shots can be swung like a flail to damage enemies. Grows bigger by killing enemies.	1
Guppy's Tail	5.100.134		Cursed?	Room Clear Awards have a 1/3 chance of being replaced with a Chest and a 1/3 chance being replaced with nothing.	2
Habit	5.100.156		Item martyr	When Isaac is hit, his active item gains 1 room's worth of charge.	2
Halo of Flies	5.100.10		Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.	2
Harlequin Baby	5.100.167		Double shot buddy	Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.	1
Headless Baby	5.100.269		Bloody friend	Spawns a familiar that follows Isaac, leaving blood creep on the ground.	1
Hive Mind	5.100.248		Giant spiders and flies	Increases the size of Blue Spiders and Blue Flies and doubles the amount of damage they deal. Also increases the effectiveness of fly and spider familiars.	2
Holy Grail	5.100.184		Flight + HP up	Grants flight and one Red Heart container.	3
Holy Mantle	5.100.313		Holy shield	Grants a shield that negates the first instance of damage taken, once per room. Does not apply to or negate self-damage ( Blood Donation Machines, etc).	4
Holy Water	5.100.178		Splash!	Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep. A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies.	3
Hot Bombs	5.100.256		Burning blast +5 bombs	Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.	1
Humbling Bundle	5.100.203		1+1 free 4Evar	Transforms Bombs, Keys, Pennies, and Red Hearts into their respective Double versions. This will occur only 50% of the time.	3
Infamy	5.100.242		Blocks damage... sometimes	Chance to block projectiles coming from any direction.	2
Infestation	5.100.148		Fly revenge	1-3 Blue Flies randomly spawn every time Isaac gets hit. 2-6 Blue Flies randomly spawn every time Isaac gets hit.	0
Infestation 2	5.100.234		Infestation shot	Spawns allied Blue Spiders from killed enemies.	4
Ipecac	5.100.149		Explosive shots	Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.	4
Iron Bar	5.100.201		DMG up + concussive tears	Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.	2
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
Jesus Juice	5.100.197		Damage + range up	+0.5 damage, +0.25 range, +0.5 tear height.	2
Judas' Shadow	5.100.311		Sweet revenge	Upon death, respawns Isaac as Dark Judas with two Black Hearts in the most recent non-hostile room.	3
Juicy Sack	5.100.266		Sticky babies	Spawns a familiar that follows Isaac and drips a trail of slow creep, spawning 1-2 Blue Spiders after each room.	2
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
Latch Key	5.100.343		Luck up	Grants 1 Soul Heart and +1 luck. Spawns 2 Keys.	2
Lazarus' Rags	5.100.332		Eternal life?	Upon dying, resurrect as Lazarus Risen in the current room with one Red Heart container and Anemic. Upon dying, resurrect as Lazarus Risen in the current room with one less Red Heart container (but no less than 1), Anemic, and a permanent +0.5 Damage up. Going to the next floor reverts him back into Lazarus, with his inherent extra life effect.	2
Leech	5.100.270		Blood sucker	Spawns a leech familiar that chases enemies, dealing ~3 damage per second. Heals a Half Red Heart whenever Leech kills an enemy.	1
Leo	5.100.302		Stompy	Isaac can destroy rocks by walking into them.	1
Libra	5.100.304		You feel balanced	Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.	1
Lil Brimstone	5.100.275		Evil friend	Grants a familiar that charges a thin Brimstone laser while Isaac is shooting.	3
Lil Haunt	5.100.277		Fear him	Spawns a familiar that chases down enemies, dealing 4 damage per second and inflicting fear.	1
Little Baggy	5.100.252		Extra pill room	Isaac can hold 2 pills at once and all cards and runes are replaced by pills.	1
Little C.H.A.D.	5.100.96		Gives kisses	Spawns a familiar who drops a Half Red Heart every 3 rooms.	2
Little Chubby	5.100.88		Attack buddy	Spawns a charger familiar that charges forward and deals contact damage to any enemies in its path.	1
Little Gish	5.100.99		Sticky friend	Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.	2
Little Steven	5.100.100		Psychic friend	Spawns a familiar who follows Isaac around and fires homing tears.	1
Loki's Horns	5.100.87		Cross tears	Gives a random chance for projectiles to fire in all 4 cardinal directions.	1
Lord of the Pit	5.100.82		Demon wings	Grants flight and +0.3 speed.	3
Lost Contact	5.100.213		Shielded tears	Isaac's tears can hit and destroy enemy projectiles. -0.16 shot speed.	2
Lucky Foot	5.100.46		Luck up	+1 luck. Increases chance of winning Shell Games and Fortune Tellers (independent from the luck stat). Converts all bad pills into good pills, without identifying them.	2
Lunch	5.100.22		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Maggy's Bow	5.100.312		HP up + you feel healthy	Gives one Red Heart Container and doubles the healing provided by Red Hearts. Also heals 1 Red Heart when obtained.	2
Magic 8 Ball	5.100.194		Shot speed up	+0.16 shot speed, spawns a random tarot card. Increases the chance of finding a Planetarium.	1
Magic Mushroom	5.100.12		All stats up!	Makes Isaac bigger. Adds one Red Heart Container, +0.3 Damage, x1.5 damage multiplier, +5.25 / +1.5 Range, and +0.3 Speed, and restores all Health.	4
Magic Scab	5.100.253		HP + luck up	Grants one full Red Heart container, +1 luck.	2
Magneto	5.100.53		Item snatcher	Pulls pickups towards Isaac.	1
Match Book	5.100.344		Evil up	Grants Isaac one Black Heart, spawns two or three Bombs.	1
MEAT!	5.100.193		DMG + HP up	Grants one full Red Heart container, +0.3 damage.	2
Midas' Touch	5.100.202		Golden touch	Enemies that touch Isaac are temporarily petrified and turn to gold. Any enemy killed while in this state will drop coins.	2
Mini Mush	5.100.71		Speed + range up	Decreases Isaac's size, making him less likely to be hit. +0.3 speed, +1.5 tear height, -4.25 range (effective range is increased). +0.3 speed, +1.50 range.	2
Missing No.	5.100.258		Syntax error	Randomizes all passive items and stats upon pickup and at the start of each succeeding floor.	1
Missing Page 2	5.100.262		Evil up. Your enemies will pay!	Grants one Black Heart. Upon taking damage that reduces Isaac's health to one heart or less, deals damage to all enemies in the room. Increases the damage of Black Hearts and The Necronomicon-like effects by 40.	0
Mitre	5.100.173		Blessing of purity	Grants a chance of converting any Red Heart pickups into Soul Hearts instead.	3
Mom's Coin Purse	5.100.195		What's all this...?	Spawns 4 random pills near Isaac.	1
Mom's Contacts	5.100.110		Freeze effect	+0.25 range. Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking.	3
Mom's Eye	5.100.55		Eye in the back of your head	Gives Isaac a chance to fire tears from the back of his head.	1
Mom's Eyeshadow	5.100.200		Charm tears	Tears have a chance to charm enemies.	1
Mom's Heels	5.100.30		Range up	+5.25 range, +0.5 tear height. Enemies that touch Isaac take 12 damage.	1
Mom's Key	5.100.199		Better chest loot +2 keys	Adds 2 keys. Chests will drop additional pickups.	3
Mom's Knife	5.100.114		Stab stab stab	Isaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.	4
Mom's Lipstick	5.100.31		Range up	+5.25 range, +0.5 tear height. Spawns one random heart.	1
Mom's Perfume	5.100.228		Fear shot + tears up	Adds a chance to shoot fear tears and decreases tear delay by 1.	2
Mom's Purse	5.100.139		More trinket room	Allows Isaac to hold one additional trinket. Drops a random trinket.	3
Mom's Underwear	5.100.29		Range up	+5.25 range, +0.5 tear height. Spawns 3-6 Blue Flies on pickup.	1
Mom's Wig	5.100.217		You feel itchy...	Adds a chance to spawn Blue Spiders when firing tears. Restores 1 Red Heart.	3
Money = Power	5.100.109		$$$ = DMG	Increases damage by 0.04 for every coin Isaac has, up to +3.96 damage at 99 coins.	3
Mongo Baby	5.100.322		Mongo friend	Spawns a familiar that copies the tears of Isaac's other familiars.	2
Monstro's Lung	5.100.229		Charged burst attack	Replaces normal tears with a charged shot that fires 14 tears in the same fashion as Monstro.	2
Mr. Mega	5.100.106		Bigger boom	Grants 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.	2
Mutant Spider	5.100.153		Quad shot	Grants quadruple shot but decreases Tears.	3
My Reflection	5.100.5		Boomerang tears	Gives Isaac's tears a boomerang effect. +1.5 range, +1 tear height, x1.6 shot speed multiplier.	0
Mysterious Liquid	5.100.317		Toxic splash damage	Tears leave a small, short lasting pool of creep on impact or when their range is depleted.	3
Mystery Sack	5.100.271		?	Spawns a familiar that drops a Heart, coin, Bomb, or Key every 5-6 rooms.	2
Number One	5.100.6		Tears up + range down	Grants +1.5 tears, but severely reduces range.	2
Odd Mushroom	5.100.121		HP + DMG up, speed down	Grants one empty Heart container, +0.3 damage, +0.25 range, +0.5 tear height, and -0.1 speed.	2
Odd Mushroom	5.100.120		Tears + speed up, DMG down	+1.7 tears, +0.3 speed, slightly reduces damage.	2
Old Bandage	5.100.219		HP up	Grants an empty Red Heart container. Adds a chance of dropping a Red Heart after taking damage.	2
Ouija Board	5.100.115		Spectral tears	Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.	2
Pageant Boy	5.100.141		Ultimate grand supreme	Spawns seven random coins around Isaac.	0
Pentagram	5.100.51		DMG up	+1 damage, increases Devil Room / Angel Room chance by 10%.	3
PHD	5.100.75		Better pills	Converts all bad pills into good pills, spawns one pill pickup, and identifies all pills. Restores two Red Hearts and increases the payout of Blood Donation Machines.	2
Piggy Bank	5.100.227		My life savings	Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.	1
Pisces	5.100.309		Tears up + knock-back shots	-1 Tear Delay, adds knock-back shots and increases tear size.	2
Placenta	5.100.218		Regeneration + HP up	Grants one full Red Heart container, and a chance to regenerate a Half Red Heart of health every minute of gameplay.	2
Polyphemus	5.100.169		Mega tears	Isaac fires huge tears that deal massive damage, but fire rate is greatly decreased. If a tear kills an enemy, it travels on with any leftover damage.	4
Proptosis	5.100.261		Short range mega tears	Tears start out massive with high damage, and then shrink down and become weaker over a short range.	4
Punching Bag	5.100.281		Scape goat	Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer.	1
Pyro	5.100.190		99 bombs	Grants 99 Bombs.	3
Pyromaniac	5.100.223		It hurts so good +5 bombs	+5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. Also grants immunity to fire.	4
Rainbow Baby	5.100.174		Random buddy	Spawns a familiar that follows Isaac around and fires tears with random effects.	1
Raw Liver	5.100.16		HP up	Grants 2 Red Heart containers and completely restores health.	2
Robo-Baby	5.100.95		Friends 'till the bbbbzzzt	Spawns a familiar that shoots Technology lasers.	1
Robo-Baby 2.0	5.100.267		We worked out all the kinks	Spawns a familiar that fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.	1
Roid Rage	5.100.14		Speed and range up	+0.6 speed, +5.25 range, +0.5 tear height. +0.3 speed, +1.50 range, +0.5 tear height.	2
Rosary	5.100.72		Tears + faith up	Grants 3 Soul Hearts. Causes The Bible to appear in any item pool. +0.5 tears.	2
Rotten Baby	5.100.268		Infested friend	Spawns a familiar that spawns a Blue Fly when Isaac shoots. It can only have one Fly at a time.	3
Rotten Meat	5.100.26		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Rubber Cement	5.100.221		Bouncing tears	Tears bounce off walls, enemies, and environmental objects.	3
Sack of Pennies	5.100.94		Gives money	Spawns a familiar that drops a coin every 2 rooms.	1
Sacred Heart	5.100.182		Homing shots + DMG up	Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, -0.25 Shot Speed, and +4.125 Range. Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, and -0.25 Shot Speed.	4
Sacrificial Dagger	5.100.172		My fate protects me	Spawns a dagger orbital familiar, blocking enemy shots and dealing a high amount of damage to enemies in contact.	2
Sad Bombs	5.100.220		Tear blasts +5 bombs	+5 Bombs. Upon exploding, bombs shoot 10 tears around them, affected by tear modifiers.	2
Safety Pin	5.100.339		Evil + range + shot speed up	Grants one Black Heart, +5.25 range, +0.5 tear height, +0.16 shot speed.	1
Sagittarius	5.100.306		Piercing shots + speed up	Increases speed by +0.2 and grants piercing tears.	3
Samson's Chains	5.100.321		The ol' ball and chain	Attaches a ball and chain to Isaac that pulls behind him that damages enemies, blocks shots, and destroys most obstacles.	1
Scapular	5.100.142		Pray for a miracle	Once per room, when Isaac is reduced to his last half heart, he is granted one Soul Heart.	2
Scorpio	5.100.305		Poison tears	Grants poison tears, which deal damage over time when inflicted.	3
Screw	5.100.255		Tears + shot speed up	+0.5 tears, +0.2 shot speed.	3
Sharp Plug	5.100.205		Infinite charge... at a cost	Damages Isaac in exchange for fully recharging Isaac's current activated item.	1
Sissy Longlegs	5.100.280		She loves you	Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders.	1
Sister Maggy	5.100.67		Friends 'till the end	Spawns a familiar that follows Isaac around shooting normal tears.	1
Skatole	5.100.9		Fly love	Flies become harmless or less dangerous depending on the type.	0
Skeleton Key	5.100.17		99 keys	Gives Isaac 99 Keys.	3
Smart Fly	5.100.264		Revenge fly	Spawns an orbital familiar that blocks enemy shots. Upon taking damage, the familiar will pursue enemies for the rest of the room, dealing 22.5 damage per second.	2
SMB Super Fan	5.100.189		All stats up	+1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +0.5 range, +1 tear height. Fully restores all red hearts.	3
Soy Milk	5.100.330		DMG down + tears way up	Tears are smaller and do much less damage, but fire in very rapid succession.	2
Speed Ball	5.100.143		Speed + shot speed up	+0.3 speed, +0.2 shot speed.	2
Spelunker Hat	5.100.91		See-through doors	Reveals type of adjacent rooms, including location for Secret Rooms and Super Secret Rooms.	2
Spider Bite	5.100.89		Slow effect	Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.	2
Spiderbaby	5.100.211		Spider revenge	When hit, spawns 1-2 Blue Spiders. When hit, spawns 3-5 Blue Spiders.	1
Spirit of the Night	5.100.159		Scary	Grants spectral tears and flight.	3
Spoon Bender	5.100.3		Homing shots	Grants Isaac homing tears.	3
Squeezy	5.100.196		Tears up	Increases tears by 0.4, spawns 2 Soul Hearts.	3
Starter Deck	5.100.251		Extra card room	Isaac can hold 2 cards at once and all pills are replaced by cards.	2
Steam Sale	5.100.64		50% off	Reduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.	2
Stem Cells	5.100.176		HP + shot speed up	Grants one full Red Heart container and +0.16 shot speed.	1
Steven	5.100.50		DMG up	Increases damage by 1.	3
Stigmata	5.100.138		DMG + HP up	+0.3 damage, grants one full Red Heart container. Heals 1 additional Red Heart.	2
Stop Watch	5.100.232		Let's slow this down a bit...	Automatically inflicts slow to all enemies in every room. Upon taking damage, inflicts slow to all enemies for the current room. Slows all enemies in every room to 80% speed.	4
Strange Attractor	5.100.315		Magnetic tears	Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.	0
Super Bandage	5.100.92		+2 hearts	Grants one full Red Heart container and 2 Soul Hearts.	2
Synthoil	5.100.345		DMG + range up	+1 damage, +5.25 range, +0.5 tear height.	3
Taurus	5.100.299		Speed down + rage is building	-0.3 Speed. Isaac builds speed while in a room with enemies. At max speed, he gains the My Little Unicorn effect for 5 seconds.	1
Tech.5	5.100.244		It's still being tested...	Isaac occasionally fires an unlimited range piercing laser alongside his normal tears. The laser can glitch, mimicking the effects of certain items and trinkets.	3
Technology	5.100.68		Laser tears	Replaces tears with a piercing laser with unlimited range.	3
Technology 2	5.100.152		Extra laser	Replaces the tears fired from Isaac's right eye with a rapid-firing low damage piercing laser. Damage down.	2
The Battery	5.100.63		Stores energy	Activated collectibles can store an extra level of charge, allowing them to be used twice in one room.	2
The Belt	5.100.28		Speed up	Increases speed by 0.3.	1
The Black Bean	5.100.180		Toot on touch	When taking damage, Isaac farts, causing poison damage to all enemies in range.	0
The Body	5.100.334		I feel all	Adds 3 Red Heart Containers.	3
The Common Cold	5.100.103		Poison damage	Adds a chance to shoot poison tears, dealing damage over time when inflicted.	1
The Compass	5.100.21		The end is near	Reveals the locations and types of all special rooms on the map, except Secret Rooms and Super Secret Rooms.	2
The Halo	5.100.101		All stats up	Grants one full Red Heart container, +0.3 damage, +0.2 tears, +0.25 range, +0.3 speed, and +0.5 tear height.	2
The Inner Eye	5.100.2		Triple shot	Grants triple shot but decreases tears.	2
The Ladder	5.100.60		Building bridges	Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.	1
The Ludovico Technique	5.100.329		Controlled tears	Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.	2
The Mark	5.100.79		DMG + speed up	Grants one Soul Heart, +1 damage, and +0.2 speed. Grants one Black Heart, +1 damage, and +0.2 speed.	3
The Mind	5.100.333		I know all	Reveals the entire map, including all special rooms and Secret Rooms.	3
The Mulligan	5.100.151		They grow inside	Tears have a 1/6 chance of spawning allied Blue Flies when they hit an enemy.	3
The Negative	5.100.328		Fate chosen	If Isaac has half a red heart or no red hearts after taking damage, all enemies in the room take significant damage. Allows entrance into the Dark Room. Also allows access to Home.	2
The Pact	5.100.80		DMG + tears up	Grants two Soul Hearts, +0.5 damage, and +0.7 tears. Grants two Black Hearts, +0.5 damage, and +0.7 tears.	3
The Parasite	5.100.104		Split shot	Isaac's tears split in two when they hit something.	3
The Peeper	5.100.155		Plop!	Spawns a familiar that floats slowly around the room on a zig-zag pattern, damaging enemies it passes through.	2
The Polaroid	5.100.327		Fate chosen	If Isaac has half a red heart or no red hearts after taking damage, he gains a shield that nullifies all types of damage for 5 seconds. Allows entrance into Chest. Also allows access to Home.	2
The Relic	5.100.98		Soul generator	Spawns a cross familiar that drops a Soul Heart after clearing enough rooms.	3
The Sad Onion	5.100.1		Tears up	Increases tears by 0.7.	3
The Small Rock	5.100.90		DMG up + speed down	+1 damage, +0.2 tears, -0.2 speed.	3
The Soul	5.100.335		I am all	Grants two Soul Hearts. Isaac gains a pulsing aura that repels enemies and projectiles.	3
The Virus	5.100.13		Poison touch + speed up	Isaac poisons enemies on contact. -0.1 speed. +0.2 speed. Poisoned enemies have a chance to drop a black heart when killed.	2
The Wafer	5.100.108		Damage resistance	All sources of damage that would cause more than one-half heart of damage are reduced to one-half heart instead.	4
There's Options	5.100.249		More options	Two items appear after defeating a Boss. Only one can be taken; the other will disappear.	3
Thunder Thighs	5.100.314		HP up + speed down + you feel stompy	Destroys rocks upon contact with Isaac. Adds one Red Heart container and lowers Speed.	1
Tiny Planet	5.100.233		Orbiting tears + range up	Massively increases Range and grants spectral tears. Tears orbit around Isaac at a fixed distance until they hit the ground.	0
Toothpicks	5.100.183		Tears + shot speed up	+0.7 tears, +0.16 shot speed.	3
Torn Photo	5.100.341		Tears + shot speed up	+0.7 tears, +0.16 shot speed.	3
Tough Love	5.100.150		Tooth shot	Adds a chance to shoot a tooth instead of a tear, which deals x3.2 Isaac's damage.	3
Transcendence	5.100.20		We all float down here...	Grants flight.	3
Treasure Map	5.100.54		Full visible map	Reveals the map of each floor. It does not identify special rooms and does not reveal the locations of Secret Rooms / Super Secret Rooms.	2
Trinity Shield	5.100.243		You feel guarded	Isaac gains a shield that protects him from enemy shots. It aims in the direction Isaac fires from.	3
Virgo	5.100.303		You feel refreshed and protected	Adds a chance to give a shield that nullifies all incoming damage for 10 seconds upon taking damage. Also converts bad pills into good pills.	2
Whore of Babylon	5.100.122		Curse up	Grants +1.5 Damage and +0.3 Speed whenever Isaac has half a Red Heart or less.	2
Wire Coat Hanger	5.100.32		Tears up	Increases tears by 0.7.	3
Wooden Spoon	5.100.27		Speed up	Increases speed by 0.3.	1
X-Ray Vision	5.100.76		I've seen everything	Reveals and opens all Secret Room and Super Secret Room entrances.	2
8 Inch Nails	5.100.359		Stick it to 'em!	+1.5 damage. Replaces Isaac's tears with nails, which have increased knockback.	3
Athame	5.100.408		Call to the void	When Isaac takes damage, a black ring briefly appears around him, dealing damage to all nearby enemies.	1
Betrayal	5.100.391		Turn your enemy	Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.	0
Binky	5.100.438		Tears up	Grants one Soul Heart, +0.75 tears and decreases Isaac's size.	3
Black Powder	5.100.420		Spin the black circle!	Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.	1
Bomber Boy	5.100.353		Cross blast + 5 bombs	+5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects player-spawned Troll Bombs.	2
Bumbo	5.100.385		Bumbo want coin!	Spawns a beggar familiar which picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo follows enemies and gains contact damage.	1
Bursting Sack	5.100.377		Spider love	Spider enemies no longer target or deal contact damage to Isaac.	1
Cambion Conception	5.100.412		Feed them hate	After taking damage a certain amount of times, a permanent demonic familiar spawns.	2
Car Battery	5.100.356		Active power up	Causes Isaac's activated item to activate twice on each use.	3
Censer	5.100.387		Peace be with you	Spawns a familiar which creates a circular aura that slows down enemies and enemy shots inside.	3
Chaos	5.100.402		!!!	Drops 1-6 random pickups on the floor. Causes items to be chosen from random item pools.	3
Charged Baby	5.100.372		Bbbzzzzzt!	Spawns a familiar that occasionally drops a Lil' Battery, gives an active item charge, or petrifies all enemies in the room.	3
Circle of Protection	5.100.423		Protect me from myself	Surrounds Isaac with a large white halo that occasionally deals Isaac's tear damage to enemies inside it, and can convert enemy shots into friendly homing tears.	2
Continuum	5.100.369		Transcendent tears	Grants spectral tears and increases range. Tears travel through walls and appear at the opposite side of the room.	2
Crack Jacks	5.100.354		HP up. Don't swallow the prize!	Grants one full Red Heart container and drops a random trinket.	2
Crown of Light	5.100.415		The untainted gain power	+2 soul hearts. While Isaac has no empty red hearts, grants 2x damage, +5.25 range, and -0.3 shot speed. Regardless of health, the crown deactivates for the current room when Isaac takes damage.	4
Curse of the Tower	5.100.371		Embrace chaos	Upon taking damage, spawns six Troll Bombs around the room, similar to the effect of XVI - The Tower.	1
Dead Eye	5.100.373		Accuracy brings power!	Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.	3
Deep Pockets	5.100.416		More money!	Allows Isaac to carry two cards or pills (or a combination of both) at the same time. Increases the coin cap to 999. If a room would otherwise yield no reward, 1-3 coins will spawn.	2
Eden's Blessing	5.100.381		Tears up + your future shines brighter	+0.7 tears up. Grants a random item at the start of the next run.	3
Empty Vessel	5.100.409		I reward an empty vessel	Grants two Black Hearts. While Isaac has no red hearts, grants flight and periodically grants an invincibility shield for a few seconds.	2
Epiphora	5.100.368		Intensifying tears	Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.	1
Evil Eye	5.100.410		Eye shot!	Adds a chance to fire a slow-moving eye that fires tears in the same direction as Isaac. The eye will be destroyed if it hits an enemy or obstacle.	2
Explosivo	5.100.401		Sticky bomb shot!	Isaac's tears have a chance to stick to enemies and explode.	2
Farting Baby	5.100.404		He farts!	Spawns a familiar that follows Isaac and blocks enemy shots. If a shot hits Farting Baby, it has a chance to fart, which charms, poisons, or knocks back nearby enemies.	1
Fate's Reward	5.100.361		Your fate beside you	A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.	2
Friend Zone	5.100.364		Friendly fly	Spawns a white attack fly that orbits somewhere between Distant Admiration and Forever Alone, dealing 45 damage per second.	1
Fruit Cake	5.100.418		Rainbow effects!	Isaac's tears gain a random effect that changes every shot.	2
GB Bug	5.100.405		Double tap glitch	Spawns a familiar that bounces diagonally around the room, applying a random status effect to enemies it hits and has a chance to re-roll pickups it passes over. Spawns a familiar that follows Isaac. Double tapping the fire button launches it forward, causing it to reroll the first monster or pickup it hits.	1
Glitter Bombs	5.100.432		Prize bombs!	+5 Bombs. Bombs have a chance to drop random pickups or charm enemies when they explode.	2
God's Flesh	5.100.398		Shrink shot!	Tears have a chance to shrink enemies, making them run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.	1
Head of the Keeper	5.100.429		Penny tears!	Isaac's tears become coins and now have a chance to drop Pennies on the floor upon successfully hitting an enemy.	2
Holy Light	5.100.374		Holy death shot	Adds a chance to fire holy tears, which will create a damaging light beam in the area if they hit an enemy.	3
Host Hat	5.100.375		Blast resistance	A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.	3
Immaculate Conception	5.100.413		Feed them love	Upon picking up a certain amount of health, spawn a permanent angelic familiar.	2
Incubus	5.100.360		Dark friend	Spawns a demonic familiar that shoots tears identical to Isaac's in terms of damage, tears, and tear effects.	4
Key Bum	5.100.388		He wants your keys!	Spawns a familiar that follows Isaac and collects Keys for himself, giving random Chests in return.	0
Kidney Stone	5.100.440		Matt's kidney stone	Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. The burst of tears also includes a kidney stone, which deals a lot of damage.	2
Lil Chest	5.100.362		What's in the box?	Spawns a chest familiar that spawns a random pickup (25% chance) or trinket (10% chance) upon clearing a room.	2
Lil Gurdy	5.100.384		A gurd of your own!	A Gurdy Jr. familiar that charges up while Isaac is firing, bouncing around the room when released and dealing contact damage based on its speed.	2
Lil Loki	5.100.435		4-way buddy!	Spawns a Loki familiar that follows Isaac and fires 4 tears in a cross pattern.	1
Lost Fly	5.100.365		Lost protector	Spawns fly familiar that moves in a straight line and circles around the first wall or obstacle it hits, dealing 105 damage per second on contact. Spawns fly familiar that moves in a straight line and circles around the first wall or obstacle it hits, dealing 56 damage per second and forcing nearby enemies to attack it.	1
Lusty Blood	5.100.411		Their blood brings rage!	Isaac's damage increases for the current room each time he kills an enemy.	3
Marked	5.100.394		Directed tears	Isaac will automatically fire tears directed at a red target on the ground. The target can be moved with tear controls. +0.7 tears, +3.15 range.	1
Maw of the Void	5.100.399		Consume thy enemy!	Charged by firing for 2.5 seconds and when released, creates a black ring around Isaac that rapidly deals damage. +1 damage, the ring can cause enemies to drop Black Hearts.	4
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.	1
Mom's Pearls	5.100.355		Range + luck up	+1.25 range, +0.5 tear height, +1 luck. Grants one Soul Heart.	2
More Options	5.100.414		There's options	Two item pedestels are presented in every Treasure Room. Only one can be taken; the other will disappear.	3
Mr. Dolly	5.100.370		Range + tears up	+0.7 tears, +5.25 range, +0.5 tear height, spawns 3 random types of Hearts on the floor when picked up.	3
Multidimensional Baby	5.100.431		ydduB Buddy	Spawns a familiar that will follow Isaac's movements on a 2.5-second delay. Tears that pass through the baby will be doubled and increase in speed.	2
My Shadow	5.100.433		Me! And my shaaaadow!	Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black friendly Charger that will attack enemies. The Charger will be killed if it is damaged too much.	0
Night Light	5.100.425		Scared of the dark?	A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.	2
Number Two	5.100.378		Uh oh...	Continuously firing tears for three seconds causes Isaac to drop a Butt Bomb, which damages and confuses all enemies in the room when it explodes.	2
Obsessed Fan	5.100.426		Follows my every move...	Spawns a familiar that follows Isaac's movements on a delay and deals 30 contact damage per second to enemies.	0
Papa Fly	5.100.430		Turret follower	Spawns a familiar that follows Isaac's movements on a 3 second delay, firing tears at nearby enemies.	1
Pay to Play	5.100.380		Money talks	+5 Coins. Doors ( except including those requiring 2 Keys), Key Blocks, and Chests all now require one Penny to open.	2
PJs	5.100.428		You feel cozy	Grants 4 Soul Hearts and fully restores Isaac's health.	2
Pupula Duplex	5.100.379		Wide shot	Gives Isaac spectral tears and gives his tears a wide arc shape, increasing their size.	2
Purity	5.100.407		Aura stat boost	Boosts one of Isaac's stats depending on the color of the aura around him. The aura disappears upon taking damage and reappears with a random color upon entering a new room. Red boosts damage, blue boosts tears, yellow boosts speed, and orange boosts range.	3
Restock	5.100.376		Never ending stores!	Causes shops to instantly restock their items when they are bought. Outside of Greed Mode, the restocked item's cost is increased after each purchase.	2
Rune Bag	5.100.389		Rune generator	Spawns a familiar that drops a random rune after clearing enough rooms.	3
Sack Head	5.100.424		More sacks!	Coins, bombs, keys, cards, runes and batteries have a chance to become sacks.	3
Scatter Bombs	5.100.366		We put bombs in your bombs!	Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.	1
Seraphim	5.100.390		Sworn friend	Spawns an angel familiar which follows Isaac and fires homing tears which deal 10 damage and have 75% shot speed.	3
Serpent's Kiss	5.100.393		The kiss of death	Tears have a chance to apply a poison effect to enemies. Isaac poisons enemies on contact. Poisoned enemies have a chance to drop a black heart when killed.	2
Spear of Destiny	5.100.400		Your destiny	In addition to tears, Isaac holds a spear in front of him which deals contact damage equal to 2x his tear damage, and occasionally inflicts fear.	1
Spider Mod	5.100.403		Mod buddy!	Displays Isaac's tear damage and enemy health bars. Spawns a familiar that wanders around and inflicts random status effects on enemies it touches. Can spawn a Lil' Battery/Blue spider upon clearing a room.	1
Sticky Bombs	5.100.367		Egg sack bombs!	+5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy.	1
Succubus	5.100.417		Damage booster	Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.	3
Sworn Protector	5.100.363		Protective friend	Spawns an orbital familiar which does 105 damage per second and attracts and blocks enemy shots. Upon blocking 10 shots in a room, it drops an Eternal Heart.	3
Tech X	5.100.395		Laser ring tears	Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the effectiveness of the ring.	4
The Wiz	5.100.358		Double wiz shot!	Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U a Wizard? pill. Isaac's tears also travel above all obstacles.	1
Toxic Shock	5.100.350		Mass poison	Upon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short-lasting pool of green creep on the ground.	3
Tractor Beam	5.100.397		Controlled tears	Increases Tears, Range, and Shot Speed. Isaac emits a beam from his face that his tears are bound to.	3
Zodiac	5.100.392		The heavens will change you	Gives Isaac a random zodiac item effect that changes every floor.	1
7 Seals	5.100.526		Lil harbingers!	Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts.	2
Acid Baby	5.100.491		Pills pills pills!	Spawns a familiar that drops a random pill every 3 rooms. Upon using a pill, all enemies in the room are poisoned.	2
Adrenaline	5.100.493		Panic = power	Increases damage based on how many empty Red Heart containers Isaac has.	1
Analog Stick	5.100.465		360 tears!	+0.35 tears up. Allows Isaac to fire tears diagonally.	2
Angelic Prism	5.100.528		Eclipsed by the moon	Spawns an orbital familiar with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.	3
Angry Fly	5.100.511		He's violent	Spawns a fly familiar that orbits around a random enemy and deals 30 damage per second to enemies it comes in contact with.	1
Apple!	5.100.443		Trick or treat?	Increases tears. Adds a chance to fire a high-damage razor blade.	3
Backstabber	5.100.506		Watch your back!	Isaac's tears deal double damage and inflict bleeding on enemies if they're facing away from Isaac.	2
Belly Button	5.100.458		What's in there?	Drops a random trinket. Grants a second trinket slot.	3
Big Chubby	5.100.473		Chub chub	Spawns a familiar that follows Isaac and charges across the room when Isaac fires, blocking shots and dealing 40.5 damage per second on contact.	1
Blanket	5.100.535		You feel Safe	Grants one Soul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.	2
Bloodshot Eye	5.100.509		Bloody friend	Spawns an orbital familiar that deals 30 damage per second and fires a randomly angled tear every 2 seconds.	1
Bozo	5.100.513		Party time!	+0.1 flat damage, grants a Soul Heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.	2
Brittle Bones	5.100.549		Everything hurts	Replaces all Red Hearts with 6 empty Bone Hearts. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up.	3
Broken Modem	5.100.514		Lag!	Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.	2
Broken Shovel	5.100.551		It feels cursed	One of two parts necessary to create Mom's Shovel. No effect if somehow obtained on its own.	4
Buddy in a Box	5.100.518		What could it be?!	Spawns a familiar with a random tear effect. The familiar is randomized at the start of each floor.	2
Camo Undies	5.100.497		Camo kid	Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused. Isaac gains +0.5 Speed while camouflaged, and gains Tears and Damage upon breaking it.	2
Compound Fracture	5.100.453		Bone tears!	Increases Range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.	3
Cone Head	5.100.457		Hard headed!	Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.	2
Contagion	5.100.466		Outbreak!	The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.	2
Dad's Lost Coin	5.100.455		I remember this...	+1.5 range. Drops a Lucky Penny.	2
Dad's Ring	5.100.546		Father's blessing	Creates a ring of light around Isaac that petrifies enemies in contact.	3
Dark Prince's Crown	5.100.442		Loss is power	When at exactly one Red Heart, increases tears, range, tear height, and shot speed.	1
Dead Tooth	5.100.446		Toxic breath	While firing, Isaac gains a green aura that poisons nearby enemies.	1
Death's List	5.100.530		Just hope you're not next...	Grants a pickup or stat upgrade if all enemies in a room are killed in the order they are marked.	2
Depression	5.100.469		:(	Spawns a familiar that leaves a trail of creep that damages enemies at 6 damage per second. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.	1
Divorce Papers	5.100.547		Tears up + you feel empty	Grants one Bone Heart, +0.7 tears, spawns a Mysterious Paper.	3
Dog Tooth	5.100.445		Bark at the moon!	+0.3 damage, +0.1 speed. Plays a howl or bark sound when entering a room with undiscovered Secret Rooms or Crawl Spaces.	1
Duality	5.100.498		You feel very balanced	Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.	1
Eucharist	5.100.499		Peace be with you	An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Womb II/ Utero II/.	3
Euthanasia	5.100.496		Needle shot	Adds a chance to fire needles that instantly kill basic enemies and deal triple damage to bosses. If a needle kills an enemy, it bursts into more tears/needles.	3
Eye of Belial	5.100.462		Possessed tears!	Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.	3
Eye of Greed	5.100.450		Gold tears!	Every 20 tears, Isaac loses 1 coin and shoots an additional gold tear that petrifies enemies and turns them into gold. Any enemy killed while in this state will drop coins.	2
Fast Bombs	5.100.517		Rapid bomb drops	Grants 7 bombs and allows bombs to be placed rapidly.	1
Finger!	5.100.467		Watch where you point that!	Spawns a finger familiar that points at enemies, dealing scaling damage.	1
Flat Stone	5.100.540		Skipping tears	Tears bounce off the floor, creating splashes. Splashes deal 25% of Isaac's tear damage to all enemies in a small area.	2
Ghost Pepper	5.100.495		Flame tears	Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them. Gives a chance to shoot blue fires alongside tears that become smaller as they travel.	3
Glaucoma	5.100.460		Blind tears!	Adds a chance to shoot tears that confuse enemies for an extremely long time.	1
Glyph of Balance	5.100.464		A gift from above	Grants 2 Soul Hearts and modifies drops from Champion monsters based on certain conditions. Also modifies room clear drops.	3
Greed's Gullet	5.100.501		Money = health!	Grants a Red Heart container for every 25 coins Isaac has.	1
Haemolacria	5.100.531		I'm seeing red...	Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.	3
Hallowed Ground	5.100.543		Portable sanctuary	Spawns a white poop familiar, which turns into a White Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. The aura also increases damage b 20% and gives homing.	1
Hushy	5.100.470		Lil hush!	Spawns a Hush familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving.	0
Jacob's Ladder	5.100.494		Electric tears	Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.	3
Jaw Bone	5.100.548		Fetch!	Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups.	1
Jumper Cables	5.100.520		Bloody recharge	Grants an active item charge every 15 enemies killed.	3
King Baby	5.100.472		Hail to the king baby	Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, other familiars stop moving.	1
Lachryphagy	5.100.532		Feed them!	Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.	2
Large Zit	5.100.502		Creep shots	Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.	1
Lead Pencil	5.100.444		He's a bleeder!	After every 15 tears fired, Isaac will fire a high-damage cluster of tears.	3
Leprosy	5.100.525		You're tearing me apart!	Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.	1
Lil Delirium	5.100.519		Delirious friend	Grants a familiar that transforms into another random familiar every 10 seconds.	2
Lil Monstro	5.100.471		Ain't he cute?	Spawns a familiar that fires clusters of tears. Must be charged before shooting.	2
Lil Spewer	5.100.537		Puking buddy	Drops a random pill, and spawns a familiar that charges up and fires creep. Using pills changes the creep type.	1
Linger Bean	5.100.447		Crying makes me toot	Constantly shooting causes Isaac to release gas clouds that can be pushed by his tears and damage nearby enemies.	0
Little Horn	5.100.503		Big brother is watching	Adds a chance to fire a piercing tear that instantly kills any enemy that it touches. Adds a chance to fire a tear that summons Big Horn's hand to crush the first enemy it hits, instantly killing monsters or greatly damaging bosses.	3
Marbles	5.100.538		Choking hazard	Spawns 3 random trinkets, 5% chance to swallow held trinket after taking damage, gaining its effect permanently.	2
Marrow	5.100.541		HP up?	Grants one Bone Heart and spawns three Red Hearts.	1
Metal Plate	5.100.449		It itches...	Grants one Soul Heart. Enemy shots have a chance to be reflected at the shooter as confusing tears.	1
Midnight Snack	5.100.456		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1