- Activates Isaac's active item just before damage would be taken.
- This still uses the item's charges so if the item is not charged, the trinket will do nothing.
- Single-use items will be consumed.
- Because the automatic item activation takes place just before taking would-be damage, this trinket becomes very powerful when holding damage-negating active items.
- Taking damage from explosions, spikes and spike rocks, Spiked Chests and Mimic Chests, the stomp attacks from Mom and Satan, Whippers and their variants, brimstone lasers (including angel lasers), self-damage items, Devil Beggars, Hell Games, Blood Donation Machines, and Confessionals will not trigger the effect.
- Super-charged items will use both of their charges. This is NOT an effect by Mom's Box or the Golden Trinket variant.
- Does not activate items in a consumable slot (such as Tainted Bethany's Lemegeton or dice items granted by Dice Bag).
- Will activate when touching Dark Esau while playing as Tainted Jacob, despite Dark Esau not technically dealing damage.
- Any self-damaging item: Self-damage occurs before enemy damage, making it almost impossible to lose Devil/Angel Room chances.
- Blood Rights: Triggers the effect on hit, at the cost of every hit making Isaac take full-heart damage.
- Book of Shadows: Activates the item, giving Isaac the shield effect for 10 seconds.
- Butter Bean / Wait What?: Isaac farts before being hit, knocking back enemies and projectiles.
- Dark Arts: Unlike many other items on this list, Dark Arts can be used to negate damage more than once per room, making it an excellent defensive item to use with Panic Button. Note that this does not work while playing as Tainted Judas.
- Dull Razor: Activates the item and gives Isaac invincibility frames before being hit, making it work similarly to Holy Mantle every two rooms. If combined with 9 Volt or AAA Battery, works every room, just like Holy Mantle.
- Glowing Hour Glass: If consumed with Void, every time Isaac is hit, if it's charged, he is sent back to the previous room without taking damage.
- Holy Mantle: Does not stop the trinket from activating, making Isaac still take damage from items such as IV Bag, while bypassing Holy Mantle's shield.
- The Lost can die this way should he carry self damaging items at the time of the hit.
- How to Jump: Makes Isaac immune to contact and tear damage while moving.
- IV Bag: Upon getting hit, activates the IV Bag instead, causing self-damage and producing money.
- Kamikaze!: Causes a highly-damaging explosion to occur every time Isaac is hit, similarly to Swallowed M80.
- Razor Blade: Isaac gains a damage boost every time he's hit, acting similarly to Red Patch, at the cost of every hit making Isaac take full-heart damage.
- Spin to Win: Has a chance to spawn additional wheels upon taking damage that last only for the current room. This is most likely a bug.
- Stitches: Isaac will teleport before damage is taken, making him much harder to hit.
- Tainted Forgotten: Triggers his active item whenever the body touches something that would damage The Soul, regardless of damage taken.
- Telekinesis: Automatically blocks any incoming shots, but the push is not strong enough to prevent contact damage.
- Yum Heart: Since the effect is triggered before taking damage, Panic Button will waste the charge with no benefit unless Isaac is already missing Red health.
|The Binding of Isaac: Rebirth|
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