Charge time can be found with the following equation:
Each tear has independant chance to have Tear Effects.
Tear falling speed ups will slightly reduce the effective range of Monstro's Lung.
Since range ups always add to tear falling speed, every range up reduces effective range.
Multi-shot effects such as 20/20 or Keeper adds 2.4 tears to the barrage per tear they normally grant. The resulting amount is rounded, and is capped at 50.
Anti-Gravity: Hover effect is overidden, but tear delay down still applies, which greatly reduces the charge time.
Blood Clot: All tears are larger, with increased damage (as opposed to every 2nd tear like Blood Clot alone).
Tears have a 50% chance to be Blood Clot tears.
Brimstone: Brimstone has priority. Does not apply Monstro's Lung's tears down. Fires 3-5 additional beams in random directions around Isaac. This effect also applies to Azazel and Tainted Azazel's versions of Brimstone.
Brimstone + Eye Sore: Overrides this synergy with a chance to shoot 1-3 additional beams in random directions.
Chocolate Milk: Reduces Isaac's tear delay by 20%, and each tear from Monstro's Lung is a charged Chocolate Milk shot, massively increasing fire rate and damage.
This does not apply to Lilith's Incubus; picking up Chocolate Milk will significantly reduce damage and increase charge time.
The tear damage and the barrage size scale with charge amount. At 50% charge, the tear damage is 100%, the barrage size reaches 100% and is capped there. At 100% charge, the tear damage is 200%.
This makes damage per second drop to 80%.
Dr. Fetus: Monstro's Lung has priority. Does not apply Dr. Fetus' tears down. Fires 6 bombs which detonate simultaneously.
Monstro's Lung has priority. Does not apply Dr. Fetus' tears down. Fires 6 mini-bombs which detonate at different times. Multi-shot effects add 1 bomb to the barrage, up to 21 bombs.
Epic Fetus: Epic Fetus has priority. Does not apply Monstro's Lung's tears down. 2-4 extra cursors rotate around the main cursor before the missiles land.
Eye Sore: Adds a chance to fire 1-3 additional barrages in random directions.
The Forgotten: The bone throw is replaced with a spray of bones. No effect on the melee swing and does not affect fire rate. The Soul behaves normally, including the tears down.
Flat Stone: All tears bounce simultaneously; the effective range is greatly increased.
Haemolacria: Monstro's Lung has priority. Applies +43 Tear Delay after Haemolacria tears down, instead of Monstro's Lung tears down. The barrage size is reduced to 4/7 (roughly 0.57), tears of which all burst.
The barrage size is 8 without any multi-shot effect. The resulting amount is rounded, and is capped at 29.
Immaculate Heart: Fires a large number of extra tears alongside the burst that begin orbiting Isaac once they reach the orbit range.
Ipecac: Fires Ipecac tears, with no increase in charge time.
Applies Ipecac's tears down.
Technology: Does not apply Monstro's Lung's tears down. Grants a charged shot, fires 12 lasers in 30° spead that arc 3-4 times. A laser can hit an enemy multiple times between their arcings.
This is equivalent of applying Monstro's Lung's tears down and its charge time, without actually altering tear delay.
Multi-shot effects add 12 lasers to the barrage, up to 128 lasers total.
Technology + Mysterious Liquid: The lasers leave creep each time they arc, resulting in a massive amount of creep.
Technology + Proptosis: The 6x damage is recovered each time they arc, nearly nullifying the distance penalty.
Tech X: Fires 3-5 extra rings in 30° spead. Extra rings deal from 50% to 100% damage of the main ring.
Additional copy of Monstro's Lung adds 3-5 more rings.
Increases Tear Delay.
Fire Rate is divided by 3.1.
The Ludovico Technique: The Ludovico Technique has priority. Does not apply Monstro's Lung's tears down. A cluster of variably sized tears orbit the main tear.
Mom's Knife: Mom's Knife has priority. Does not apply Monstro's Lung's tears down. Fires additional knives depending on charge amount, each dealing 2x tear damage. Fires 3-5 knives at maximum charge.
Mom's Wig: Charging an attack spawns spiders in rapid succession.
Spawns spiders upon firing, not charging. The amount of spiders spawned is dependent on luck.
Monstro's Lung: Additional copies of this item, such as from Diplopia / Crooked Penny, add 10/ 12 tears to the barrage.
This effects is equivalent of adding 4/ 5 multi-shot effects. The items which have priority over Monstro's Lung or override it (e.g. Brimstone/C Section) benefit from this multi-shot effect.
My Reflection: Tears stay in the air much longer and consistently, allowing better reach and more focused blasts before the tears returning to Isaac.
Technology Zero: Replaces tears with white technology beams that slowly branch out like lightning.
Tractor Beam: All the tears follow the beam at different heights without spreading out, making it much easier for multiple tears to hit a target.
Kidney Stone: If Monstro's Lung is picked up while Kidney Stone is ready to fire, charge time for Monstro's Lung will be significantly decreased.
Only stat effects from Kidney Stone apply.
Lachryphagy: The tears merge into one giant tears a while after being fired, and instantly burst. Without Piercing, most of the damage is often wasted. Without Spectral, the tears often collide against obstacles due to their size.
Loki's Horns / Mom's Eye: Adds a chance to fire single tears in the other direction(s).
Adds a chance to fire barrages in the other direction(s).
Strange Attractor: Due to the high concentration of tears enemies will be pulled into Isaac at great force, in certain cases enough force to pull enemies through rocks.
Tech.5: Occasionally fires a linear laser while charging.
Technology: If picked up after Technology, Monstro's Lung has no effect. Technology will override Monstro's Lung with a very low firerate.
Technology has priority. Does not apply Monstro's Lung's tears down. Fires extra lasers in random directions.
Technology 2: Fires a linear laser while charging.