- Rerolls all pedestal items in a room by subtracting their internal ID number by one until a valid item is rolled. This effect occurs per item and is independent of any other items in the room.
- Items created by using Spindown Dice are not considered "normally generated" and can be encountered again in their normal pools if they were not picked up.
- The following is a list of rerolls notable because the items rerolled into are considered to be very powerful:
- Abaddon: Rerolls into Monstro's Lung.
- Alabaster Box: Rerolls into Book of Virtues.
- Azazel's Rage: Rerolls into Twisted Pair.
- Belly Jelly: Rerolls into Glitched Crown.
- Big Fan: Rerolls into Dark Bum.
- Blood Bag: Rerolls into Brimstone.
- Blue Map: Rerolls into 20/20.
- Bot Fly: Rerolls into Death Certificate.
- Cambion Conception: Rerolls into Lusty Blood.
- Chemical Peel: Rerolls into Mutant Spider.
- Consolation Prize: Rerolls into Revelation.
- Cricket's Body: Rerolls into Pyromaniac.
- Daddy Longlegs: Rerolls into Polyphemus, which can be rerolled into Epic Fetus.
- Dark Prince's Crown: Rerolls into Mega Blast.
- Deep Pockets: Rerolls into Crown of Light.
- E. Coli: Rerolls into Infestation 2.
- Eden's Soul: Rerolls into D Infinity.
- Fate's Reward: Rerolls into Incubus.
- Host Hat: Rerolls into Holy Light.
- Isaac's Tomb: Rerolls into Echo Chamber.
- Key Piece 1: Rerolls into Death's Touch.
- Knife Piece 1: Rerolls into Mega Mush.
- Knockout Drops: Rerolls into R Key.
- Lachryphagy: Rerolls into Haemolacria.
- Lazarus' Rags: Rerolls into Godhead.
- Little Gish: Rerolls into The Relic.
- Magneto: Rerolls into Dr. Fetus.
- Maggy's Bow: Rerolls into Judas' Shadow.
- Missing Page 2: Rerolls into Proptosis, which can be rerolled into Black Candle.
- My Reflection: Rerolls into Cricket's Head, which can be rerolled into Spoon Bender
- Nancy Bombs: Rerolls into Rock Bottom.
- Ouija Board: Rerolls into Mom's Knife.
- Sack of Sacks: Rerolls into Eucharist.
- Sanguine Bond: Rerolls into Sacred Orb.
- Sol: Rerolls into The Stairway.
- Spear of Destiny: Rerolls into Maw of the Void.
- Spiderbaby: Rerolls into Gnawed Leaf.
- Thunder Thighs: Rerolls into Holy Mantle.
- Toothpicks: Rerolls into Sacred Heart.
- Tough Love: Rerolls into Ipecac.
- Ventricle Razor: Rerolls into Tech X.
- The Virus: Rerolls into Magic Mushroom.
- Tiny Planet: Rerolls into Stop Watch.
- Wavy Cap: Rerolls into Psy Fly, which can be rerolled into Red Key, which can be rerolled into Spirit Sword.
- The following is a list of rerolls notable because the item rerolled into is difficult to obtain under normal circumstances:
- Bomb Bag: Rerolls into A Pony, which is only obtainable otherwise by defeating Headless Horseman.
- Boom!: Rerolls into A Dollar, which is only obtainable otherwise by playing Slot Machines.
- Butter Bean: Rerolls into Head of Krampus, which is only obtainable otherwise by defeating Krampus.
- Halo of Flies: Rerolls into Skatole, which is only obtainable by playing Shell Games.
- Guppy's Paw: Rerolls into A Lump of Coal, which is only obtainable otherwise by defeating Krampus or as a possible drop from Mystery Gift.
- Lil Abaddon: Rerolls into C Section, which is only obtainable otherwise by starting with it as Eden or through Death Certificate.
- Mom's Bra: Rerolls into Tammy's Head, which is only obtainable otherwise through Crane Games.
- Mucormycosis: Rerolls into Mom's Shovel, which is only obtainable otherwise through Broken Shovel on the process to unlock The Forgotten.
- Papa Fly: Rerolls into Head of the Keeper, which is only obtainable otherwise by bombing Shopkeepers.
- Pentagram: Rerolls into Steven, which is only obtainable otherwise as a rare drop from killing Steven.
- Purgatory: Rerolls into Dogma, which is only obtainable otherwise by defeating Dogma or using Death Certificate.
- Sacred Heart: Rerolls into White Pony, which is only obtainable otherwise by defeating Conquest.
- Sausage: Rerolls into Dad's Note, which is only obtainable otherwise in the special Mausoleum/ Gehenna II boss room.
- Spelunker Hat: Rerolls into The Small Rock, which is only obtainable otherwise from destroying a Tinted Rock or from Crane Games.
- Spirit of the Night: Rerolls into Crystal Ball, which is only obtainable otherwise by playing a Fortune Teller machine.
- Spirit Shackles: Rerolls into Redemption, which is only obtainable otherwise by playing a Confessional or Sacrifice Room after taking a devil deal.
- Voodoo Head: Rerolls into Pluto, which can be rerolled into the rest of the Planetarium items, which are only obtainable otherwise from a Planetarium.
- Glitched Crown / Tainted Isaac: Rerolling a cycling item will reduce the ID number of the displayed item by 1 and randomize all other options. This may allow Isaac to acquire items with large ID numbers by jumping to a higher ID.
- Tainted Lost: Allows him to obtain items otherwise hardcoded to never naturally spawn for him.
- Book of Virtues: Spawns an extra wisp and rerolls all of Isaac's wisps. All of the wisps will reroll into the same type of wisp.
- Car Battery: All future rerolls turn into the item that is 2 less than the previous ID.
- The Sad Onion: Disappears upon being rerolled, as its internal ID number is 1.
- TMTRAINER / Corrupted Data: Glitch items will disappear if rerolled.
- A spindown die is a type of die used as a life counter for Magic: The Gathering. It is a D20 with the numbers laid out in a sequential pattern, to allow for the face-up number to be changed easily when a player's life goes up or down.
- The item's color scheme matches the D8 die included in The Binding of Isaac: Four Souls card game, which is used as a spindown die to keep track of an enemy's health.
- Spindown Dice is the only die item that cannot be copied by the D Infinity.
- Spindown Dice itself will be rerolled into Anima Sola, while Hypercoagulation rerolls into the dice.
- Using Spindown Dice on Smart Fly rerolls into Clear Rune, which is the only Repentance added item to reroll from a Rebirth one. This is due to the item taking up a previously unused item id.
- Hidden items are defined with the attribute
|Bug!||When playing as Tainted Isaac and holding Butter!, the pedestal that Spindown Dice spawns on is considered a new pedestal generation, causing it to cycle to a different item and Spindown Dice will be fully charged if picked back up.|