Treasure Room (Item Pool)

The Treasure Room item pool contains the majority of the game's items. All of the items in this pool are able to be found in the Treasure Room.

Activated Collectibles[]

Name	ID	Weight	Description
Anarchist Cookbook	5.100.65	1	Spawns six Troll Bombs around the room.
The Bean	5.100.111	1	Isaac farts, poisoning any enemy in close range.
Best Friend	5.100.136	1	Spawns a decoy Isaac that explodes after 5 seconds, dealing 110 185 damage. Enemies will always target the decoy and ignore Isaac.
Blood Rights	5.100.186	1	Upon use, takes a full heart of health and deals 40 damage to all enemies in the room.
Bob's Rotten Head	5.100.42	1	Upon use, Isaac holds a poison bomb which can be thrown in the cardinal directions and explodes on impact.
Book of Revelations	5.100.78	1	Gives one Soul Heart, increases the chance for a Devil Room or Angel Room to appear after defeating the floor's boss, and replaces the boss of the current floor with a Harbinger if possible.
Book of Secrets	5.100.287	1	Gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.
Book of Shadows	5.100.58	1	Creates a protective shield, nullifying all types of damage in the current room for 10 seconds.
The Book of Sin	5.100.97	1	Generates a random pickup, pill, card, or rune.
Box of Spiders	5.100.288	1	Spawns 1-4 Blue Spiders that deal 2.5x damage to enemies. Spawns 4-8 Blue Spiders that deal 2x damage to enemies.
Butter Bean	5.100.294	1	Upon use, Isaac farts and knocks back nearby enemies and projectiles. Enemies pushed into walls or obstacles take 12 damage.
Crack the Sky	5.100.160	1	Summons 5 beams of light in random locations on the ground, dealing large amounts of damage to any enemies that touch them.
D10	5.100.285	1	Re-rolls all monsters in the room. Will attempt to re-roll monsters into ones with a similar amount of HP.
D100	5.100.283	1	Combines the effects of D4, The D6, and D20. Combines the effects of D1, D4, The D6, D7, D8, D10, D12, and D20.
D20	5.100.166	1	Rerolls all pickups in the current room.
D4	5.100.284	1	Rerolls all of Isaac's passive items.
The D6	5.100.105	1	Re-rolls all items in the current room into other items, depending on the current room's Item Pool.
Dad's Key	5.100.175	1	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.
Dead Sea Scrolls	5.100.124	1	Triggers the effect of a random activated item from a list of possible options (not every activated item is included).
Deck of Cards	5.100.85	1	Gives Isaac a random card.
Doctor's Remote	5.100.47	1	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.
Flush!	5.100.291	1	Turns all non-boss monsters in the room into poop. Instantly kills poop-themed bosses.
Forget Me Now	5.100.127	1	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.
The Gamekid	5.100.93	1	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.
The Hourglass	5.100.66	1	All enemies in the room are slowed for 8 seconds.
How to Jump	5.100.282	1	Upon use, Isaac jumps in the direction he is currently moving, allowing travel over obstacles and enemies.
Isaac's Tears	5.100.323	1	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.
Kamikaze!	5.100.40	1	Creates an explosion around Isaac, damaging him and nearby enemies as well as destroying obstacles.
Lemon Mishap	5.100.56	1	Creates a tiny pool of yellow creep, damaging enemies that cross it.
Magic Fingers	5.100.295	1	Uses 1 coin to deal a large amount of damage to all enemies in the room.
Mom's Bottle of Pills	5.100.102	1	Gives Isaac a random pill.
Mom's Bra	5.100.39	1	Petrifies all enemies in the current room for around 4 seconds.
Mom's Pad	5.100.41	1	Inflicts fear to all enemies in the room for 5 seconds.
Monster Manual	5.100.123	1	Spawns a familiar from a specific selection for the current room. Spawns a familiar from a specific selection for the current floor.
Monstro's Tooth	5.100.86	1	A friendly Monstro jumps on a random enemy, dealing 120 area damage. Lands on Isaac if used in a room without enemies.
Mr. Boom	5.100.37	1	Places a Mr. Mega bomb that deals 110 damage.
My Little Unicorn	5.100.77	1	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.
The Pinking Shears	5.100.107	1	Gives flight for the current room, while turning Isaac's body into a fast, high damage familiar.
The Poop	5.100.36	1	Spawns a pile of poop where Isaac is standing and knocks back nearby enemies. May yield pickups like regular poop.
Prayer Card	5.100.146	1	Gives an Eternal Heart per use.
Remote Detonator	5.100.137	1	Bombs placed by Isaac only explode when Remote Detonator is used. Gives 5 bombs.
Satanic Bible	5.100.292	1	Gives one Black Heart. Replaces the boss room item on the current floor with a Devil Deal.
Scissors	5.100.325	1	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.
Shoop Da Whoop!	5.100.49	1	Fires a laser from Isaac's mouth.
Spider Butt	5.100.171	1	Deals 10 damage to all enemies in the room and slows them for 4 seconds. Enemies killed by Spider Butt spawn Blue Spiders.
Telepathy for Dummies	5.100.192	1	Gives homing tears for the current room. Also gives +3 range.
Teleport!	5.100.44	1	Teleports Isaac to a random room on the current floor.
Undefined	5.100.324	1	Teleports Isaac to the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.
Unicorn Stump	5.100.298	1	Gives invulnerability and increased speed for five seconds, but removes the ability to shoot tears.
Yum Heart	5.100.45	1	Restores one full Red Heart.
Blank Card	5.100.286	1	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.
Crystal Ball	5.100.158	1	Upon use, reveals the map (except the Super Secret Room) and drops a Soul Heart or random card/rune.
Notched Axe	5.100.147	1	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.
D12	5.100.386	1	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.
D7	5.100.437	1	Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.
D8	5.100.406	1	Re-rolls Isaac's Damage, Tears, Range, and Speed.
Friendly Ball	5.100.382	1	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.
Glass Cannon	5.100.352	1	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.
Glowing Hour Glass	5.100.422	1	Rewinds time, putting Isaac back in the previous room and undoing anything that happened in the current room.
Kidney Bean	5.100.421	1	Isaac farts, charming all nearby enemies.
Mega Bean	5.100.351	1	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.
Mine Crafter	5.100.427	1	Places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies when used. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.
Teleport 2.0	5.100.419	1	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.
Black Hole	5.100.512	1	Throws a black hole on the ground which sucks in and damages enemies.
Book of the Dead	5.100.545	1	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.
Brown Nugget	5.100.504	1	Spawns a stationary fly turret that fires tears at nearby enemies.
Clicker	5.100.482	1	Transforms Isaac into a random character and removes the last item collected.
Crooked Penny	5.100.485	1	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.
D1	5.100.476	1	Duplicates a random pickup in the room. The new pickup may be different than the original (i.e. a different card, etc).
Dataminer	5.100.481	1	Displaces enemy sprites for the current room, randomly increases one stat and decreases another.
Metronome	5.100.488	1	Grants a random item effect for the current room.
Pause	5.100.478	1	Freezes all enemies until a fire button is pressed.
Sharp Straw	5.100.507	1	Damages all enemies in the room. Has a chance to drop a half red heart or half soul heart if an enemy is hit.
Sprinkler	5.100.516	1	Upon use, creates a stationary sprinkler that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects.
Telekinesis	5.100.522	1	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.
D Infinity	5.100.489	1	Grants a random die item that changes each use. Acts as any die item, and can by cycled by pressing the drop key.
Wait What?	5.100.484	1	Isaac farts, sending out rock waves.
Anima Sola	5.100.722	1	Chains down the nearest enemy for 5 seconds, preventing them from acting.
Bag of Crafting	5.100.710	1	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.
Decap Attack	5.100.729	1	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.
Everything Jar	5.100.720	1	Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects.
Fortune Cookie	5.100.557	1	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.
Free Lemonade	5.100.578	1	Creates a large pool of yellow creep beneath Isaac.
Friend Finder	5.100.687	1	Spawns a random friendly monster that mimics Isaac's movements and attacks.
Golden Razor	5.100.555	1	Spends five coins to increase Isaac's damage by 1.2 for the current room.
Larynx	5.100.611	1	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.
Meat Cleaver	5.100.631	1	Splits all enemies in the room into two smaller versions of themselves with much less health.
The Scooper	5.100.605	1	Summons a Peeper familiar for the current room, which leaves a trail of red creep.
Spin to Win	5.100.655	1	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.
Stitches	5.100.635	1	Passively spawns a familiar that moves in the direction Isaac shoots. On use, Isaac swaps places with the familiar.
Sumptorium	5.100.713	1	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.
Suplex!	5.100.709	1	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.
Tammy's Head	5.100.38	1	Shoots 10 tears in a circle around Isaac, which retain the Damage, Shot Speed, and special effects (such as poison) of Isaac's tears.
Yuck Heart	5.100.639	1	Gives Isaac a Rotten Heart.
Esau Jr.	5.100.703	0.5	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.
Eternal D6	5.100.609	0.5	Rerolls all items in the room. Each item has a 30% chance to disappear instead.
Gello	5.100.728	0.5	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.
Plum Flute	5.100.650	0.5	Summons the boss Baby Plum to fight for Isaac in the current room.
Mega Mush	5.100.625	0.1	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.
Spindown Dice	5.100.723	0.1	Transforms all items in the room by decreasing their internal ID number.

Passive Collectibles[]

Name	ID	Weight	Description
20/20	5.100.245	1	Isaac fires two tears at once, one from each eye. 0.75x damage multiplier.
3 Dollar Bill	5.100.191	1	Gives Isaac a random tear effect every room. Gives Isaac a random tear effect every few seconds.
<3	5.100.15	1	Grants Isaac one Red Heart container and fully restores Isaac's health.
???'s Only Friend	5.100.320	1	Spawns a controllable familiar that deals 37.5 damage per second on touch. It can be moved using the shooting directional keys
Abel	5.100.188	1	Spawns a familiar that mirrors Isaac's movements and shoots in the opposite direction.
Anemic	5.100.214	1	+5 +1.5 range. After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room.
Ankh	5.100.161	1	Upon death, Isaac will respawn as ??? in the most recent non-hostile room, with 3 Soul Hearts.
Anti-Gravity	5.100.222	1	-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.
Aquarius	5.100.308	1	A trail of blue creep is left behind Isaac, which damages enemies. The creep inherits most of Isaac's tear effects, like homing, etc.
Aries	5.100.300	1	+0.25 Speed. Running into enemies while at a high speed will deal damage. Does not prevent contact damage.
BBF	5.100.272	1	Spawns a familiar that flies around the room in a zig-zag pattern and explodes on contact with an enemy. Respawns after ten seconds.
Ball of Tar	5.100.231	1	Adds a chance to shoot slowing tears. Isaac leaves a trail of slowing creep behind as he moves, impeding enemies' speed.
Best Bud	5.100.274	1	When hit, spawns a quickly orbiting attack fly similar to Forever Alone for the current room dealing 75 150 damage per second.
Big Fan	5.100.279	1	Spawns a large orbital familiar that blocks enemy shots and deals 30 damage per second to enemies.
The Black Bean	5.100.180	1	When taking damage, Isaac farts, causing poison damage to all enemies in range.
Blood of the Martyr	5.100.7	1	Increases damage by 1, and turns Isaac's tears into blood tears.
Bloody Lust	5.100.157	1	Increases Isaac's damage whenever he takes damage, up to six times. The bonus resets when entering a new floor.
Bob's Brain	5.100.273	1	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.
Bob's Curse	5.100.140	1	Gives 5 bombs and grants Isaac's bombs a poison effect. Gives Isaac immunity to poison.
Bobby-Bomb	5.100.125	1	+5 bombs. Bombs gain a homing effect, slowly moving towards the nearest enemy.
Bomb Bag	5.100.131	1	Spawns a familiar that drops a bomb every 3 rooms.
Boom!	5.100.19	1	Grants 10 bombs.
Brother Bobby	5.100.8	1	A familiar that follows Isaac around shooting normal tears.
Bucket of Lard	5.100.129	1	Grants two empty full Red Heart containers and heals Isaac by half a Red Heart, but decreases speed by 0.2.
Bum Friend	5.100.144	1	Spawns a familiar that picks up coins for himself, giving random pickups in return. Does not spawn collectibles.
Butt Bombs	5.100.209	1	+5 bombs. Bombs now cloud up the screen, briefly damaging and confusing all enemies.
Cain's Other Eye	5.100.319	1	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.
Cancer	5.100.301	1	Adds 3 Soul Hearts. Grants The Wafer effect for the current room after taking damage.
Capricorn	5.100.307	1	Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +1.5 / +0.75 Range, and -1.0 Tear Delay, and gives 1 Bomb, Coin, and Key.
Celtic Cross	5.100.162	1	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.
Charm of the Vampire	5.100.62	1	Heals Isaac for half of a Red Heart for every 13 enemies killed. +0.3 damage.
Chemical Peel	5.100.154	1	Tears fired from the left eye have +2 flat damage.
Chocolate Milk	5.100.69	1	Grants charged tears that deal greater damage when fully charged.
The Common Cold	5.100.103	1	Adds a chance to shoot poison tears, dealing damage over time when inflicted.
Cricket's Body	5.100.224	1	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.
Cricket's Head	5.100.4	1	Increases Damage by 0.5, and increases damage multiplier by x1.5.
Cupid's Arrow	5.100.48	1	Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.
Cursed Eye	5.100.316	1	Grants charged tears that can be fired in a tight burst. Getting hit while charging will teleport Isaac to another room.
Daddy Longlegs	5.100.170	1	Daddy Long Legs' shadow follows Isaac and occasionally stomps enemies for 40 damage total.
Dark Bum	5.100.278	1	Spawns a familiar that follows Isaac around and collects Red Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward.
Dead Bird	5.100.117	1	After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~5 damage per second.
Dead Onion	5.100.336	1	Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.
Demon Baby	5.100.113	1	Spawns a familiar that follows Isaac and automatically fires at enemies in its reach.
Distant Admiration	5.100.57	1	Spawns an attack fly that circles further out than Halo of Flies, but closer than Forever Alone, dealing 75 damage per second.
Dr. Fetus	5.100.52	1	Tears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.
Dry Baby	5.100.265	1	Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.
Eve's Mascara	5.100.310	1	Doubles damage, halves tears stat, and greatly reduces shot speed.
Experimental Treatment	5.100.240	1	Randomly increases and decreases some of Isaac's stats. Increases four random stats and decreases the other two.
Fire Mind	5.100.257	1	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.
Forever Alone	5.100.128	1	Spawns an attack fly that orbits a long distance from Isaac, dealing 30 damage per second.
Gemini	5.100.318	1	Spawns a conjoined familiar which chases enemies close to Isaac, dealing ~8 damage per second.
Ghost Baby	5.100.163	1	Spawns a familiar that follows Isaac around and fires spectral tears.
Gimpy	5.100.225	1	Gives chance of spawning a Soul Heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.
Gnawed Leaf	5.100.210	1	After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
Guillotine	5.100.206	1	Isaac's head is removed from his body and floats around him as an orbital. Gives +1 damage and grants -1 tear delay.
Halo of Flies	5.100.10	1	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.
Harlequin Baby	5.100.167	1	Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.
Headless Baby	5.100.269	1	Spawns a familiar that follows Isaac, leaving blood creep on the ground.
Holy Water	5.100.178	1	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.
Hot Bombs	5.100.256	1	Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Infamy	5.100.242	1	Chance to block projectiles coming from any direction.
Infestation 2	5.100.234	1	Spawns allied Blue Spiders from killed enemies.
Infestation	5.100.148	1	1-3 Blue Flies randomly spawn every time Isaac gets hit. 2-6 Blue Flies randomly spawn every time Isaac gets hit.
The Inner Eye	5.100.2	1	Grants triple shot but decreases tears.
Ipecac	5.100.149	1	Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Iron Bar	5.100.201	1	Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Isaac's Heart	5.100.276	1	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.
Juicy Sack	5.100.266	1	Spawns a familiar that follows Isaac and drips a trail of slow creep, spawning 1-2 Blue Spiders after each room.
Lazarus' Rags	5.100.332	1	Upon dying, resurrect as Lazarus Risen in the current room with one Red Heart container and Anemic.
Leech	5.100.270	1	Spawns a leech familiar that chases enemies, dealing ~3 damage per second. Heals a Half Red Heart whenever Leech kills an enemy.
Leo	5.100.302	1	Isaac can destroy rocks by walking into them.
Libra	5.100.304	1	Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.
Lil Brimstone	5.100.275	1	Grants a familiar that charges a thin Brimstone laser while Isaac is shooting.
Lil Haunt	5.100.277	1	Spawns a familiar that chases down enemies, dealing 4 damage per second and inflicting fear.
Little C.H.A.D.	5.100.96	1	Spawns a familiar who drops a Half Red Heart every 3 rooms.
Little Chubby	5.100.88	1	Spawns a charger familiar that charges forward and deals contact damage to any enemies in its path.
Little Gish	5.100.99	1	Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.
Little Steven	5.100.100	1	Spawns a familiar who follows Isaac around and fires homing tears.
Loki's Horns	5.100.87	1	Gives a random chance for projectiles to fire in all 4 cardinal directions.
Lost Contact	5.100.213	1	Isaac's tears can hit and destroy enemy projectiles. -0.16 shot speed.
Lucky Foot	5.100.46	1	+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.
The Ludovico Technique	5.100.329	1	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.
Maggy's Bow	5.100.312	1	Gives one Red Heart Container and doubles the healing provided by Red Hearts. Also heals 1 Red Heart when obtained.
Magneto	5.100.53	1	Pulls pickups towards Isaac.
Midas' Touch	5.100.202	1	Enemies that touch Isaac are temporarily petrified and turn to gold. Any enemy killed while in this state will drop coins.
Mini Mush	5.100.71	1	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.
Mitre	5.100.173	1	Grants a chance of converting any Red Heart pickups into Soul Hearts instead.
Mom's Contacts	5.100.110	1	+0.25 range. Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking.
Mom's Eye	5.100.55	1	Gives Isaac a chance to fire tears from the back of his head.
Mom's Eyeshadow	5.100.200	1	Tears have a chance to charm enemies.
Mom's Perfume	5.100.228	1	Adds a chance to shoot fear tears and decreases tear delay by 1.
Mom's Wig	5.100.217	1	Adds a chance to spawn Blue Spiders when firing tears. Restores 1 red heart.
Money = Power	5.100.109	1	Increases damage by 0.04 for every coin Isaac has, up to +3.96 damage at 99 coins.
Mongo Baby	5.100.322	1	Spawns a familiar that copies the tears of Isaac's other familiars.
Monstro's Lung	5.100.229	1	Replaces normal tears with a charged shot that fires 14 tears in the same fashion as Monstro.
Mr. Mega	5.100.106	1	Grants 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.
The Mulligan	5.100.151	1	Tears have a 1/6 chance of spawning allied Blue Flies when they hit an enemy.
Mutant Spider	5.100.153	1	Grants quadruple shot but decreases tears.
My Reflection	5.100.5	1	Gives Isaac's tears a boomerang effect. +1.5 range, +1 tear height, x1.6 shot speed multiplier.
Mysterious Liquid	5.100.317	1	Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
Mystery Sack	5.100.271	1	Spawns a familiar that drops a Heart, coin, bomb, or key every 5-6 rooms.
Number One	5.100.6	1	Grants +1.5 tears, but severely reduces range.
Odd Mushroom	5.100.121	1	Grants one empty Heart container, +0.3 damage, +0.25 range, +0.5 tear height, and -0.1 speed.
Odd Mushroom	5.100.120	1	+1.7 tears, +0.3 speed, slightly reduces damage.
Ouija Board	5.100.115	1	Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
The Parasite	5.100.104	1	Isaac's tears split in two when they hit something.
The Peeper	5.100.155	1	Spawns a familiar that floats slowly around the room on a zig-zag pattern, damaging enemies it passes through.
PHD	5.100.75	1	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.
Piggy Bank	5.100.227	1	Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
Pisces	5.100.309	1	-1 Tear Delay, adds knock-back shots and increases tear size.
Polyphemus	5.100.169	1	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.
Proptosis	5.100.261	1	Tears start out massive with high damage, and then shrink down and become weaker over a short range.
Punching Bag	5.100.281	1	Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer.
Rainbow Baby	5.100.174	1	Spawns a familiar that follows Isaac around and fires tears with random effects.
Robo-Baby 2.0	5.100.267	1	Spawns a familiar that fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.
Robo-Baby	5.100.95	1	Spawns a familiar that shoots Technology lasers.
Roid Rage	5.100.14	1	+0.6 speed, +5.25 range, +0.5 tear height. +0.3 speed, +1.50 range, +0.5 tear height.
Rosary	5.100.72	1	Adds 3 Soul Hearts. The Bible will appear in any item pool. Also a +0.5 tears up.
Rotten Baby	5.100.268	1	Spawns a familiar that spawns a Blue Fly when Isaac shoots. It can only have one Fly at a time.
Rubber Cement	5.100.221	1	Tears bounce off walls, enemies, and environmental objects.
SMB Super Fan	5.100.189	1	+1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +0.5 range, +1 tear height. Fully restores all red hearts.
Sack of Pennies	5.100.94	1	Spawns a familiar that drops a coin every 2 rooms.
Sacrificial Dagger	5.100.172	1	Spawns a dagger orbital familiar, blocking enemy shots and dealing a high amount of damage to enemies in contact.
Sad Bombs	5.100.220	1	+5 Bombs. Upon exploding, bombs shoot 10 tears around them, affected by tear modifiers.
The Sad Onion	5.100.1	1	Increases tears by 0.7.
Sagittarius	5.100.306	1	Increases speed by +0.2 and grants piercing tears.
Samson's Chains	5.100.321	1	Attaches a ball and chain to Isaac that pulls behind him that damages enemies, blocks shots, and destroys most obstacles.
Scapular	5.100.142	1	Once per room, when Isaac is reduced to his last half heart, he is granted one Soul Heart.
Scorpio	5.100.305	1	Grants poison tears, which deal damage over time when inflicted.
Sissy Longlegs	5.100.280	1	Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders.
Sister Maggy	5.100.67	1	Spawns a familiar that follows Isaac around shooting normal tears.
Smart Fly	5.100.264	1	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.
Soy Milk	5.100.330	1	Tears are smaller and do much less damage, but fire in very rapid succession.
Speed Ball	5.100.143	1	+0.3 speed, +0.2 shot speed.
Spelunker Hat	5.100.91	1	Reveals type of adjacent rooms, including location for Secret Rooms and Super Secret Rooms.
Spider Bite	5.100.89	1	Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Spiderbaby	5.100.211	1	When hit, spawns 1-2 Blue Spiders. When hit, spawns 3-5 Blue Spiders.
Spoon Bender	5.100.3	1	Grants Isaac homing tears.
Stem Cells	5.100.176	1	Grants one full Red Heart container and +0.16 shot speed.
Stigmata	5.100.138	1	Increases damage, and adds 1 heart container.
Strange Attractor	5.100.315	1	Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.
Super Bandage	5.100.92	1	Grants one full Red Heart container and 2 Soul Hearts.
Taurus	5.100.299	1	-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.
Tech.5	5.100.244	1	Isaac occasionally fires an unlimited range piercing laser alongside his normal tears. The laser can glitch, mimicking the effects of certain items and trinkets.
Technology 2	5.100.152	1	Replaces the tears fired from Isaac's right eye with a rapid-firing low damage piercing laser. Damage down.
Technology	5.100.68	1	Replaces tears with a piercing laser with unlimited range.
Thunder Thighs	5.100.314	1	Destroys rocks upon contact with Isaac. Adds one Red Heart container and lowers Speed.
Tiny Planet	5.100.233	1	Range up and makes shot tears revolve around Isaac until they drop.
Tough Love	5.100.150	1	Adds a chance to shoot a tooth instead of a tear, which deals x3.2 Isaac's damage.
Virgo	5.100.303	1	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.
The Virus	5.100.13	1	Isaac poisons enemies on contact. -0.1 speed. +0.2 speed. Poisoned enemies have a chance to drop a black heart when killed.
The Wafer	5.100.108	1	All sources of damage that would cause more than one-half heart of damage are reduced to one-half heart instead.
X-Ray Vision	5.100.76	1	Reveals and opens all Secret Room and Super Secret Room entrances.
The Halo	5.100.101	1 0.5	Grants one full Red Heart container, +0.3 damage, +0.2 tears, +0.25 range, +0.3 speed, and +0.5 tear height.
Magic Mushroom	5.100.12	1 0.5	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.
Pyromaniac	5.100.223	1 0.5	+5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. Also grants immunity to fire.
The Body	5.100.334	1 0.2	Adds 3 Red Heart Containers.
Death's Touch	5.100.237	1 0.2	+1.5 damage, -0.3 tears. Tears are replaced with large piercing scythes.
Holy Mantle	5.100.313	1 0.2	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).
The Mind	5.100.333	1 0.2	Reveals the entire map, including all special rooms and Secret Rooms.
Mom's Knife	5.100.114	1 0.2	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.
The Relic	5.100.98	1 0.2	Spawns a cross familiar that drops a Soul Heart after clearing enough rooms.
The Soul	5.100.335	1 0.2	Grants two Soul Hearts. Isaac gains a pulsing aura that repels enemies and projectiles.
Pyro	5.100.190	1 0.1	Grants 99 Bombs.
A Quarter	5.100.74	1	Gives Isaac 25 coins.
Epic Fetus	5.100.168	1	Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
Judas' Shadow	5.100.311	1	Upon death, respawns Isaac as Dark Judas with two Black Hearts in the most recent non-hostile room.
8 Inch Nails	5.100.359	1	+1.5 damage. Replaces Isaac's tears with nails, which have increased knockback.
Betrayal	5.100.391	1	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.
Bomber Boy	5.100.353	1	+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.
Bumbo	5.100.385	1	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.
Bursting Sack	5.100.377	1	Spider enemies no longer target or deal contact damage to Isaac.
Continuum	5.100.369	1	Grants spectral tears and increases range. Tears travel through walls and appear at the opposite side of the room.
Curse of the Tower	5.100.371	1	Upon taking damage, spawns six Troll Bombs around the room, similar to the effect of XVI - The Tower.
Dead Eye	5.100.373	1	Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Eden's Blessing	5.100.381	1	+0.7 tears up. Grants a random item at the start of the next run.
Epiphora	5.100.368	1	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.
Evil Eye	5.100.410	1	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.
Explosivo	5.100.401	1	Isaac's tears have a chance to stick to enemies and explode.
Farting Baby	5.100.404	1	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.
Fate's Reward	5.100.361	1	A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.
Friend Zone	5.100.364	1	Spawns a white attack fly that orbits somewhere between Distant Admiration and Forever Alone, dealing 45 damage per second.
Fruit Cake	5.100.418	1	Isaac's tears gain a random effect that changes every shot.
GB Bug	5.100.405	1	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.
Glitter Bombs	5.100.432	1	+5 bombs. Bombs have a chance to drop random pickups or charm enemies when they explode.
God's Flesh	5.100.398	1	Tears have a chance to shrink enemies, making them run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.
Host Hat	5.100.375	1	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.
Key Bum	5.100.388	1	Spawns a familiar that follows Isaac and collects Keys for himself, giving random Chests in return.
Kidney Stone	5.100.440	1	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.
Lil Chest	5.100.362	1	Spawns a chest familiar that spawns a random pickup (25% chance) or trinket (10% chance) upon clearing a room.
Lil Gurdy	5.100.384	1	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.
Lil Loki	5.100.435	1	Spawns a Loki familiar that follows Isaac and fires 4 tears in a cross pattern.
Lost Fly	5.100.365	1	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.
Lusty Blood	5.100.411	1	Isaac's damage increases for the current room each time he kills an enemy.
Marked	5.100.394	1	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.
Milk!	5.100.436	1	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.
Multidimensional Baby	5.100.431	1	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.
Obsessed Fan	5.100.426	1	Spawns a familiar that follows Isaac's movements on a delay and deals 30 contact damage per second to enemies.
Papa Fly	5.100.430	1	Spawns a familiar that follows Isaac's movements on a 3 second delay, firing tears at nearby enemies.
Pupula Duplex	5.100.379	1	Gives Isaac spectral tears and gives his tears a wide arc shape, increasing their size.
Purity	5.100.407	1	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.
Rune Bag	5.100.389	1	Spawns a familiar that drops a random rune every 5-6 ( 7-8) rooms.
Scatter Bombs	5.100.366	1	Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Seraphim	5.100.390	1	Spawns an angel familiar which follows Isaac and fires homing tears which deal 10 damage and have 75% shot speed.
Serpent's Kiss	5.100.393	1	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.
Sticky Bombs	5.100.367	1	+5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy.
Tech X	5.100.395	1	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.
Toxic Shock	5.100.350	1	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.
Tractor Beam	5.100.397	1	Increases Tears, Range, and Shot Speed. Isaac emits a beam from his face that his tears are bound to.
The Wiz	5.100.358	1	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.
Zodiac	5.100.392	1	Gives Isaac a random zodiac item effect that changes every floor.
Holy Light	5.100.374	1 0.2	Adds a chance to fire holy tears, which will create a damaging light beam in the area if they hit an enemy.
Acid Baby	5.100.491	1	Spawns a familiar that drops a random pill every 3 rooms. Upon using a pill, all enemies in the room are poisoned.
Adrenaline	5.100.493	1	Increases damage based on how many empty Red Heart containers Isaac has.
Analog Stick	5.100.465	1	+0.35 tears up. Allows Isaac to fire tears diagonally.
Angry Fly	5.100.511	1	Spawns a fly familiar that orbits around a random enemy and deals 30 damage per second to enemies it comes in contact with.
Apple!	5.100.443	1	Increases tears. Adds a chance to fire a high-damage razor blade.
Backstabber	5.100.506	1	Isaac's tears deal double damage and inflict bleeding on enemies if they're facing away from Isaac.
Big Chubby	5.100.473	1	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.
Bloodshot Eye	5.100.509	1	Spawns an orbital familiar that deals 30 damage per second and fires a randomly angled tear every 2 seconds.
Bozo	5.100.513	1	+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.
Brittle Bones	5.100.549	1	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.
Camo Undies	5.100.497	1	Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused.
Compound Fracture	5.100.453	1	Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Cone Head	5.100.457	1	Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.
Contagion	5.100.466	1	The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.
Dead Tooth	5.100.446	1	While firing, Isaac gains a green aura that poisons nearby enemies.
Depression	5.100.469	1	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.
Dog Tooth	5.100.445	1	+0.3 damage, +0.1 speed. Plays a howl or bark sound when entering a room with undiscovered Secret Rooms or Crawl Spaces.
Euthanasia	5.100.496	1	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.
Fast Bombs	5.100.517	1	Grants 7 bombs and allows bombs to be placed rapidly.
Finger!	5.100.467	1	Spawns a finger familiar that points at enemies, dealing scaling damage.
Flat Stone	5.100.540	1	Tears bounce off the floor, creating splashes. Splashes deal 25% of Isaac's tear damage to all enemies in a small area.
Ghost Pepper	5.100.495	1	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.
Glaucoma	5.100.460	1	Adds a chance to shoot tears that confuse enemies for an extremely long time.
Haemolacria	5.100.531	1	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.
Hallowed Ground	5.100.543	1	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.
Hushy	5.100.470	1	Spawns a Hush familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving.
Jacob's Ladder	5.100.494	1	Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
Jaw Bone	5.100.548	1	Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups.
Lachryphagy	5.100.532	1	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.
Large Zit	5.100.502	1	Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.
Lead Pencil	5.100.444	1	After every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Leprosy	5.100.525	1	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.
Lil Monstro	5.100.471	1	Spawns a familiar that fires clusters of tears. Must be charged before shooting.
Lil Spewer	5.100.537	1	Drops a random pill, and spawns a familiar that charges up and fires creep. Using pills changes the creep type.
Linger Bean	5.100.447	1	Constantly shooting causes Isaac to release gas clouds that can be pushed by his tears and damage nearby enemies.
Metal Plate	5.100.449	1	Grants one Soul Heart. Enemy shots have a chance to be reflected at the shooter as confusing tears.
Mom's Razor	5.100.508	1	Spawns an orbiting razor that deals contact damage and inflicts bleeding on enemies, causing them to slowly take damage over time.
Mystery Egg	5.100.539	1	Spawns an egg familiar, which cracks into a random friendly monster when Isaac is hurt. The egg regenerates upon entering a different room.
Parasitoid	5.100.461	1	Adds a chance to fire an egg sack which creates slowing creep and spawns a Blue Fly or Blue Spider upon hitting an enemy.
Pointy Rib	5.100.544	1	Spawns a bone familiar that hovers back and forth in front of Isaac, dealing damage equal to Isaac's damage.
Pop!	5.100.529	1	Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.
Shard of Glass	5.100.448	1	Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room. Taking damage causes Isaac to bleed, spraying a volley of blood in the direction he fires. Bleeding will eventually damage him, but it can be stopped by picking up a Red Heart.
Sinus Infection	5.100.459	1	Adds a chance to fire a booger that sticks to enemies and deals damage over time.
Slipped Rib	5.100.542	1	Spawns a bone familiar that circles around Isaac and reflects enemy shots.
Sulfuric Acid	5.100.463	1	+0.3 damage. Adds a chance to fire acidic tears which can destroy obstacles.
Technology Zero	5.100.524	1	Connects Isaac's tears with electricity that can damage enemies.
Varicose Veins	5.100.452	1	Taking damage releases a ring of 10 high damage tears.
YO LISTEN!	5.100.492	1	+1 luck. Spawns a fairy familiar that points out Secret Rooms, Crawl Space entrances, and tinted rocks.
120 Volt	5.100.559	1	Repeatedly zaps enemies that are close to Isaac.
Akeldama	5.100.641	1	While in an uncleared room, Isaac forms a trail of bloody tears that drags behind him, bursting and dealing damage upon contact with enemies.
Almond Milk	5.100.561	1	Quadruples fire rate, with x0.3 damage multiplier. Tears are given random worm trinket effects.
Belly Button	5.100.458	1	Drops a random trinket. Grants a second trinket slot.
Belly Jelly	5.100.690	1	Causes enemies to bounce off of Isaac, dealing damage to them if they hit an enemy or obstacle. Also gives Isaac the chance to deflect enemy shots.
Bird Cage	5.100.610	1	The first time Isaac takes damage in a room, a familiar leaps on an enemy, dealing damage and releasing a rock wave. For the rest of the room, it chases enemies similar to Dead Bird.
Bird's Eye	5.100.616	1	Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them.
Blood Bombs	5.100.614	1	Grants a Red Heart container and restores 5 hearts. Bombs leave behind damaging red creep. Isaac can place bombs at the cost of half a heart if he doesn't have any.
Blood Puppy	5.100.565	1	Spawns a familiar that chases enemies. After killing enough enemies, it becomes more powerful but will also try to hurt Isaac. Attacking it returns it to normal.
Bloody Gust	5.100.695	1	The first 6 times Isaac takes damage on a given floor, he gains Speed and Tears for the rest of the floor, up to a maximum of +1.02 and +3.00, respectively.
Boiled Baby	5.100.607	1	Gives Isaac a familiar that fires chaotic bursts of tears in all directions.
Bone Spurs	5.100.683	1	Enemies spawn floating bones on death, which block shots and damage/repel enemies that touch them.
Bot Fly	5.100.629	1	Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles.
Candy Heart	5.100.671	1	Gives Isaac a permanent stat boost whenever he heals with red heart pickups.
Cracked Orb	5.100.675	1	Unlocks doors and reveals a random room on the map when Isaac takes damage.
C Section	5.100.678	1	Replaces tears with fetuses that chase down enemies and deal contact damage. Each shot requires a brief charge up.
Cube Baby	5.100.652	1	Spawns an ice cube familiar that slides around when walked into. It slows and deals contact damage, freezing monsters it kills.
Dirty Mind	5.100.576	1	Destroying poop spawns Dip Familiars that follow Isaac and damage enemies. Destroying different types of poop spawns different Dips with special effects.
Empty Heart	5.100.676	1	If Isaac has one red heart or less at the beginning of a floor, he gains an empty red heart container.
Eye Sore	5.100.558	1	Causes Isaac to occasionally fire extra tears in random directions while shooting.
Freezer Baby	5.100.608	1	Spawns a shooting familiar that has a chance to petrify enemies, and Freezes monsters upon killing them.
Fruity Plum	5.100.649	1	Gives Isaac a miniature Baby Plum familiar that propels itself diagonally around the room, firing tears behind itself as it travels.
Ghost Bombs	5.100.727	1	+5 bombs. Bombs become spectral and spawn ghosts that deal contact damage to enemies and explode after 10 seconds.
Giant Cell	5.100.658	1	Causes Isaac to spawn micro-Isaacs when he takes damage, which chase and shoot at nearby enemies.
Hemoptysis	5.100.726	1	Double-tapping a fire button causes Isaac to sneeze blood, dealing damage to enemies in front of him.
Hypercoagulation	5.100.724	1	After Isaac takes damage from an enemy or donates health, launches red hearts from Isaac that despawn after 1.5 seconds.
IBS	5.100.725	1	Causes Isaac to throw poop, create buffing creep, or drop bombs while fighting enemies.
It Hurts	5.100.560	1	Releases a ring of tears and increases tears for the current room when Isaac takes damage.
Keeper's Kin	5.100.717	1	Rocks and props spawn blue spiders over time while in a room with enemies, and spawn two blue spiders when destroyed.
Knockout Drops	5.100.637	1	Adds a chance to shoot a fist tear that has extremely high knockback and confuses enemies.
Lil Dumpy	5.100.615	1	Gives Isaac a Dumpy familiar that pushes, confuses, or poisons nearby enemies and flies in a random direction after taking damage.
Lil Portal	5.100.681	1	A familiar that flies forward, consuming pickups in its path. Each one will increase its size and damage and spawn a Blue Fly. Every four pickups, it opens a portal that leads to an unexplored room.
Lodestone	5.100.617	1	Gives Isaac the chance to fire tears that magnetize enemies they hit, causing them to attract nearby pickups and enemies, as well as tears/shots from all sources.
Lost Soul	5.100.612	1	Creates a ghostly familiar that closely follows behind Isaac. It dies in one hit, but respawns at the start of the next floor. Each time it survives until the next floor, it rewards Isaac with Soul Hearts, Eternal Hearts, or an item.
Montezuma's Revenge	5.100.680	1	While firing, Isaac charges up a short-ranged Brimstone-like diarrhea beam that shoots behind him.
Mucormycosis	5.100.553	1	Gives Isaac the chance to fire spore tears that stick to enemies and blow up after a few seconds, dealing damage and poisoning nearby enemies and releasing more spores.
Nancy Bombs	5.100.563	1	Gives Isaac +5 bombs and gives his bombs random bomb synergies.
Playdough Cookie	5.100.570	1	Grants multicolored tears. Each color comes with a different status or tear effect.
Polydactyly	5.100.454	1	Allows Isaac to carry two cards, pills, or any combination of both. Spawns one random card, rune, or pill.
Psy Fly	5.100.581	1	Spawns a fly orbital familiar that chases and deflects enemy shots and converts them into homing tears that deal 2 damage. Turns some Fly enemies into friendly Blue Flies if it touches them while deflecting shots.
Quints	5.100.661	1	The first five enemies killed in a room will spawn stationary shooting familiars where they died.
Rocket in a Jar	5.100.583	1	+5 bombs. If Isaac is currently firing, placing a bomb will instead shoot a fast-moving, explosive rocket in the direction he's facing.
Rotten Tomato	5.100.618	1	Adds a chance to fire tears that Mark enemies. Marked enemies are attacked by other enemies.
The Intruder	5.100.575	1	A familiar burrows in Isaac's head, firing 4 slowing tears. Upon taking damage, there's a chance it will burst out of Isaac's head, spawning blue spiders and chasing enemies for the current room.
The Swarm	5.100.693	1	Spawns eight orbital flies, which turn into Blue Flies after they block a shot. Each time a room is cleared, spawns another orbital fly.
Tinytoma	5.100.645	1	Gives Isaac a Teratoma orbital that blocks shots, deals contact damage, and splits into smaller versions of itself upon taking damage. The smaller versions break into blue spiders.
Tooth and Nail	5.100.663	1	Isaac periodically turns into a spiked statue, briefly becoming invulnerable and dealing contact damage.
Vasculitis	5.100.657	1	Enemies explode into tears upon death, which inherit the effects of Isaac's tears.
Worm Friend	5.100.682	1	Gives Isaac a Nerve Ending familiar that burrows out of the ground to grab and deal damage to enemies over time.
Astral Projection	5.100.677	0.2	Causes Isaac to turn into a ghost if he gets hit while in an uncleared room, giving him flight and spectral tears and blocking the next hit he takes.
Skeleton Key	5.100.17	0.1	Gives Isaac 99 Keys.