Spawns a familiar that drops a random rune after clearing enough rooms.
Runes are dropped alternating every 5 or 6 rooms.
Runes are dropped alternating every 7 or 8 rooms.
Notes
If there are no runes unlocked, it will drop cards instead.
Rune Bag will also drop Soul Stones if any have been unlocked.
If less than 6 runes are unlocked, it can drop a Rune Shard instead of a rune.
Familiars that follow behind Isaac have a certain priority in how close their position is to him over other familiars, with Rune Bag having the lowest priority at 6th / 8th and thus being farther from Isaac than familiars of different priorities.
Synergies
BFFS!: The drop rate is improved to every 4-5 rooms.