Adrenaline
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Adrenaline is a passive item added in The Binding of Isaac: Afterbirth †.
Effects
- Gives Isaac a flat damage up based on how many empty Heart containers he has.
The damage up given is 0.2 for each empty Red Heart container Isaac has.
The damage up given is ((2 × MissingHearts) ^ 1.6) × 0.1, where MissingHearts is the number of full red hearts of health missing. The amount of damage gained this way is exponential, so each heart lost will provide a bigger bonus than the last.
- Damage ups are only applied for every fully empty heart container.
- This item belongs to the
Spun set. Collecting three items from this set will transform Isaac into a buff berserker.
Notes
- This item has no effect on characters that can't have any Red Heart containers, unless
Bone Hearts are collected. If a Bone Heart is gone, so does the Adrenaline damage. This means that Adrenaline is only truly useless on 
The Lost. - This item affects both
Keeper and 
Tainted Keeper; empty Coin Hearts increase damage. - As
The Forgotten, empty Bone Hearts increase damage, but if the Bone Hearts are broken, the damage buff is lost. - The maximum damage bonus from Adrenaline is 14.05 normally, 16.15 with Bone Hearts, and 30.9 for Magdalene with
Birthright.
Synergies
- Birthright +
Magdalene: Allows Magdalene to gain more damage than the other characters can because of her 6 additional heart containers. 
Blood Oath: Activates the damage up effect of Adrenaline for the resulting empty heart containers at the start of each floor.
Empty Heart: Activates the damage up effect of Adrenaline if an empty heart container is granted at the beginning of each floor.
Rock Bottom: Allows Isaac to keep the damage up after refilling hearts.
In-game Footage
Trivia
- Before v1.06.0190, Adrenaline was named Adderline.
- Despite having its name changed, Adrenaline's item sprite is named collectibles_493_adderline in the game files.
- Adrenaline is a hormone produced by the body in situations of high stress that increases blood circulation, breathing, and other things in preparation for the natural flight or fight reflex.
- Adrenaline causes characters to have an animation that makes them look like they are breathing rapidly. The more health they're missing, the more exaggerated the animation is.
 Syringes
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| Trinkets |
 The Binding of Isaac: Rebirth
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