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.

This pool is also used for random items spawned in any other regular room or room without a specified item pool such as Vaults, Arcades, Boss Rush etc.

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, damaging and poisoning any enemy in close range.
Best Friend	5.100.136	1	Spawns a decoy Isaac that explodes after 5 seconds. Enemies will always target the decoy and ignore Isaac.
Blood Rights	5.100.186	1	Takes a full heart of health and deals 40 damage to all enemies in the room. Repeated uses in the same room only take half a heart.
Bob's Rotten Head	5.100.42	1	Isaac holds a poison Bomb which can be thrown in a cardinal direction and explodes on impact.
Book of Revelations	5.100.78	1	Increases the chance of a Devil Room / Angel Room appearing while held. Upon use, gives one Soul Heart, 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. If all effects are active, X-Ray Vision is provided for the floor instead. Highlights any Tinted Rocks and rocks with Crawl Space in the room.
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	Spawns a random coin, heart, bomb, key, battery, pill or card near Isaac.
Box of Spiders	5.100.288	1	Spawns 1-4 Blue Spiders that deal 2.5× Isaac's damage to enemies. Spawns 4-8 Blue Spiders that deal 2× Isaac's damage to enemies.
Butter Bean	5.100.294	1	Isaac farts and knocks back nearby enemies and projectiles. Enemies pushed into walls or obstacles take `10 + 2 * (floor - 1)` damage.
Crack the Sky	5.100.160	1	Creates five beams of light around the room, dealing high damage to any enemies that touch them.
D10	5.100.285	1	Re-rolls all monsters in the room. Replaces all monsters in the room with weaker monsters.
D100	5.100.283	1	Activates the combined effects of D4, The D6, and D20. Activates the combined effects of D1, D4, The D6, D7, D8, D10, D12, and D20.
D20	5.100.166	1	Re-rolls all pickups, chests, and trinkets in the current room.
D4	5.100.284	1	Re-rolls 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	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. Floods the current room.
Forget Me Now	5.100.127	1	Restarts the current floor with a new layout. Any items and pickups from the original floor are kept.
The Gamekid	5.100.93	1	Transforms Isaac into a rainbow-colored chomping creature for 6.5 seconds. Grants invulnerability, inflicts fear on all enemies, and has a chance of replenishing a Half Red Heart every time an enemy is killed.
The Hourglass	5.100.66	1	All enemies in the room are slowed for 8 seconds.
How to Jump	5.100.282	1	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 use his damage, range, shot speed, and tear effects. Shooting charges this item. Tears from this item have a +5 flat damage.
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 small pool of yellow creep, damaging enemies that cross it. The pool lasts for the entire room.
Magic Fingers	5.100.295	1	Consumes one Penny to deal 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 4 seconds.
Mom's Pad	5.100.41	1	Inflicts fear to all enemies in the room for 4 seconds. Spawns a blue fly.
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 damage in an area. Targets Isaac if used in a room without enemies.
Mr. Boom	5.100.37	1	Places a Mr. Mega Bomb that deals 110 damage. Places a Mr. Mega Bomb that deals 185 damage.
My Little Unicorn	5.100.77	1	Grants invulnerability and +0.28 speed for six seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.
The Pinking Shears	5.100.107	1	Separates Isaac's head from his body for the current room, granting flight and turning the body into a familiar that chases enemies.
The Poop	5.100.36	1	Spawns a pile of Poop where Isaac is standing and knocks back nearby enemies. It may yield pickups like regular poop.
Prayer Card	5.100.146	1	Gives Isaac an Eternal Heart.
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	Grants 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 that deals twice Isaac's tear damage.
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 six 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 recharge time is based on the power of the card.
Crystal Ball	5.100.158	1	Reveals the map (except the Super Secret Room and Ultra Secret Room) and drops a Soul Heart or random card or rune. While held, increases the chance of finding a Planetarium.
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 obstacles. Re-rolls most types of obstacles in the current room into other random obstacles.
D7	5.100.437	1	Restarts the current room and respawns all monsters, 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 Hourglass	5.100.422	1	Rewinds time, putting Isaac back in the previous room and undoing anything that happened in the current room. Can only be used three times per floor, after which it functions like The Hourglass until the next floor.
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 about 1.5 seconds, poisons any enemies near Isaac. The fart also sends a rock wave across the room in the direction Isaac is facing. The fart also creates a Mama Mega! explosion.
Mine Crafter	5.100.427	1	Places a Movable TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used again in the same room while the previous TNT barrel is still intact, remotely detonates 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 and destroys nearby obstacles.
Book of the Dead	5.100.545	1	Creates a friendly Bony, Black Bony, or an orbital bone for each enemy killed in the current room. Creates a friendly Bony, Black Bony, Bone Fly, Revenant, Big Bony, or an orbital bone for each enemy killed in the current room.
Brown Nugget	5.100.504	1	Spawns a stationary fly turret that lasts for the current room and fires tears at nearby enemies.
Clicker	5.100.482	1	Transforms Isaac into another random character and removes the last item collected.
Crooked Penny	5.100.485	1	Has a 50% chance to double all items, ChestError: The given entity ("chest") does not exist. s, trinkets, and pickups in the room. If the effect fails, spawns a Penny and the other 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 and randomly increases one of Isaac's stats while decreasing another. Turns all items in the room into glitched items with random effects.
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 HeartError: The given entity ("half soul heart") does not exist. if an enemy is hit. Damages all enemies in the room. Has a chance to drop a Half Red Heart if an enemy is hit.
Sprinkler	5.100.516	1	Creates a stationary sprinkler for the current room that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects.
Telekinesis	5.100.522	1	Any enemy shots that come near Isaac for the next three seconds are held in place then fired back.
D infinity	5.100.489	1	Has the effect of a random die item that changes each use. Replicates the effect of almost any die item, and can be cycled through by pressing the drop key.
Wait What?	5.100.484	1	Isaac farts, sending out a circular rock wave that destroys obstacles and hurts enemies.
Anima Sola	5.100.722	1	Chains down the nearest enemy for 5 seconds, preventing them from moving or attacking.
Bag of Crafting	5.100.710	1	Swipes a bag that 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 5 pennies to grant +1.2 damage for the current room. Grants 5 pennies when picked up for the first time.
Larynx	5.100.611	1	Isaac shouts, damaging and pushing away nearby enemies. The shout gets stronger the more charges the item has. Larynx gains 1 charge whenever Isaac takes damage, in addition to charging normally.
Meat Cleaver	5.100.631	1	Splits all enemies in the room into two smaller versions of themselves with much less health.
Razor Blade	5.100.126	1	Damages Isaac for one heart and grants +1.2 damage for the current room. Subsequent uses in the same room only take half a heart.
The Scooper	5.100.605	1	Summons The Peeper for the current room, which leaves a trail of red creep.
Spin to Win	5.100.655	1	Gives +0.5 speed and greatly increases the rotation speed and damage of orbitals for 3 seconds. Passively gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage.
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 jumps and 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, range, shot speed, and special effects (such as poison) of Isaac's tears. Tears from this item have a +25 flat damage bonus.
Yuck Heart	5.100.639	1	Grants 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	Re-rolls all items in the room. Each item has a 25% chance to disappear instead.
Gello	5.100.728	0.5	Spawns a demon familiar for the current room attached to Isaac that 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 Baby Plum to fight for Isaac for roughly 10 seconds, dealing high damage.
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	Reduces the internal ID number of all items in the room by one, turning them into the item with that number.

Passive Collectibles

Name	ID	Weight	Description
20/20	5.100.245	1	Isaac fires two tears at once, one from each eye. 0.8× 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. Spawns a familiar that mirrors Isaac's movements and shoots towards him.
Anemic	5.100.214	1	After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room. +5 range. +1.5 range.
Ankh	5.100.161	1	Upon death, Isaac will respawn as ??? in the previous room, with 3 Soul Hearts.
Anti-Gravity	5.100.222	1	Tears float in position until firing ceases, after which they will fly off in the direction they were shot in. -2 Tear Delay. +1 Fire Rate.
Aquarius	5.100.308	1	A trail of blue creep is left behind Isaac, which damages enemies. The creep scales with damage and inherits most tear effects.
Aries	5.100.300	1	+0.25 Speed. Running into enemies while at a high speed will deal damage. Prevents Isaac from taking contact damage while moving at high speed.
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 that deals high damage.
Big Fan	5.100.279	1	Spawns a large, slow-moving orbital familiar that blocks enemy shots and deals 30 damage per second to enemies. Reduces the speed other orbitals rotate at.
The Black Bean	5.100.180	1	When taking damage, Isaac farts, poisoning enemies in range. When taking damage, Isaac farts five times, poisoning and knocking back nearby enemies and leaving lingering poison clouds.
Blood of the Martyr	5.100.7	1	+1 damage. Isaac shoots 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	+5 Bombs. Grants Isaac's bombs a poison effect. They also leave a lingering poison cloud, and Isaac becomes immune 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	Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage. He shoots more frequently than most familiars.
Bucket of Lard	5.100.129	1	Grants two empty Red Heart containers, heals Isaac for a Half Red Heart, -0.2 speed. Grants two Red Heart containers, -0.2 speed.
Bum Friend	5.100.144	1	Spawns a familiar that picks up coins for himself, giving random pickups in return. Can spawn items from the Beggar item pool.
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 slowly floats around the room on a zig-zag pattern and shoots normal tears in the same direction as Isaac. Spawns a familiar that follows Isaac and fires tears in random cardinal directions that copy Isaac's tears and tear effects and scale with damage.
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 Range, and -1.0 Tear Delay, and gives 1 Bomb, Penny, and Key. Adds 1 Red Heart container, gives +0.5 Damage, +0.1 Speed, +0.75 Range, and +0.5 Fire Rate, and gives 1 Bomb, Penny, 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 a Half 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	When tears hit an object or deplete their range, they spawn 4 smaller tears, whose range and damage scale with Isaac's. Grants -1 tear delay and reduces range. Grants +0.5 fire rate and reduces range.
Cricket's Head	5.100.4	1	Increases Damage by 0.5, and increases damage multiplier by ×1.5.
Cupid's Arrow	5.100.48	1	Grants Isaac triangular 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 ~4 damage per second. As long as Isaac's HP is at one half heart ( no matter the type of heart), Dead Bird will remain active between rooms.
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.
E. Coli	5.100.236	1	Enemies that touch Isaac are transformed into Poop.
Eve's Mascara	5.100.310	1	Doubles damage, halves tears stat, and greatly reduces shot speed. Doubles damage, 0.66x tears multiplier, 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 ~6.43 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 becomes an orbital familiar that blocks shots and deals contact damage. Tears are still fired from the rotating head. +1 damage, -1 tear delay. +1 damage, +0.5 fire rate.
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	+5 Bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Infamy	5.100.242	1	Gives Isaac a 50% 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	Isaac shoots three tears at once with lower fire rate.
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	+0.3 damage. 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. Upon dying, resurrect as Lazarus Risen in the current room with one less Red Heart container, Anemic, and +0.5 Damage. Transform into Lazarus when reaching the next floor.
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. -0.15 shot speed.
Lucky Foot	5.100.46	1	+1 luck. Improves Isaac's chances at various random events (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 Pennies.
Mini Mush	5.100.71	1	Decreases Isaac's size, making him less likely to be hit. +0.3 speed, +1.5 tear falling speed, -4.25 range (effective range is increased). +0.3 speed, +2.5 range.
Mitre	5.100.173	1	Grants a chance of converting any Red Heart pickups that spawn into Soul Hearts instead.
Mom's Contacts	5.100.110	1	Adds a chance to shoot petrifying tears. +0.25 range. +1.5 range.
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. Decreases tear delay by 1. +0.5 fire rate.
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	+5 Bombs. Increases the size, blast radius, and damage of Isaac's bombs.
The Mulligan	5.100.151	1	Tears have a 16.67% chance of spawning allied Blue Flies when they hit an enemy.
Mutant Spider	5.100.153	1	Isaac shoots four tears at once with lower fire rate.
My Reflection	5.100.5	1	Gives Isaac's tears a boomerang effect. +1.5 range, +1 tear falling speed, x1.6 shot speed multiplier. 2x + 1.5 range, +1.5 damage, -1 luck, 1.6x 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 falling speed, and -0.1 speed. Grants one full Heart container, +1 damage, +1.5 range, and -0.2 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). +0.5 tears.
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 slowly floats around the room in a zig-zag pattern, damaging enemies it passes through. Increases the damage of tears from Isaac's left eye by 35%.
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 or two additional pennies.
Pisces	5.100.309	1	-1 Tear Delay, adds knock-back shots and increases tear size. +0.5 Fire Rate, 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.
Pyromaniac	5.100.223	1	+5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. Also grants immunity to fire.
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 falling speed. +0.3 speed, +2.5 range
Rosary	5.100.72	1	Grants 3 Soul Hearts. Causes The Bible to appear in any item pool. +0.5 tears.
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 falling speed. Fully restores all red hearts. +1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +2.5 range. 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	+0.7 tears.
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. Briefly charms enemies on contact.
Sister Maggy	5.100.67	1	Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage. Spawns a familiar that follows Isaac around shooting tears that deal 6 damage.
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 damage.
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. Reveals rooms up to 2 rooms away and blocks projectiles falling from above.
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	Spawns 1-2 Blue Spiders when Isaac takes damage. Spawns 3-5 Blue Spiders when Isaac takes damage.
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. Heals 1 additional Red Heart
Stigmata	5.100.138	1	+0.3 damage, grants one full Red Heart container. Heals 1 additional Red Heart.
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	Massively increases Range and grants spectral tears. Tears orbit around Isaac at a fixed distance until they hit the ground.
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	Most 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 falling speed. Grants one full Red Heart container, +0.3 damage, +0.2 tears, +1.5 range, and +0.3 speed. Heals 1 additional Red Heart.
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 Range, +0.3 Speed, and restores all Health. Makes Isaac bigger. Adds one Red Heart Container, +0.3 Damage, x1.5 damage multiplier, +2.5 Range, +0.3 Speed, and restores all Health.
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 from a hostile source once per room.
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.
Epic Fetus	5.100.168	1 0.1	Instead of tears, firing creates a crosshair which can be moved freely. A missile is dropped in the location after 1.5 seconds, exploding for high damage.
Pyro	5.100.190	1 0.1	Grants 99 Bombs.
A Quarter	5.100.74	1	Gives Isaac 25 coins.
Judas' Shadow	5.100.311	1	Upon death, respawns Isaac as Black Judas with two Black Hearts in the previous 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	Charms all enemies in the room when Isaac takes damage. Enemies are able to damage each other. If an enemy is damaged by another enemy, they will attack that enemy instead of 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 is destroyed when 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 20% 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	Isaac is occasionally forced to stop firing and charge an attack that launches a massive piercing, spectral kidney stone and a barrage of tears. -0.2 speed, decreases range.
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 a fly familiar that moves in a straight line and circles around the first wall or obstacle it hits. It deals 105 damage per second on contact. It deals 56 damage per second and forces nearby enemies to attack it.
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, increases range.
Milk!	5.100.436	1	Spawns a glass familiar that follows Isaac. After Isaac takes damage, the milk spills, and he gains -2 tear delay ( +1.0 fire rate) until leaving the room Spawns a glass familiar that follows Isaac. The milk will block projectiles, and upon blocking 10, the milk spills, giving Isaac +1.0 fire rate for the rest of the floor.
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.
Number Two	5.100.378	1	Continuously firing tears for three seconds causes Isaac to drop a Butt Bombs bomb, which damages and confuses all enemies in the room when it explodes.
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 after clearing enough rooms.
Scatter Bombs	5.100.366	1	+5 Bombs. Isaac's bombs explode into 2-4 tiny bombs.
Seraphim	5.100.390	1	Spawns an angel familiar who 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 2-5 Blue Spiders on kill. Bombs leave a long-lasting puddle of slowing creep. Spawns 1-2 Blue Spiders or Blue Flies when bombs damage enemies.
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	Isaac's tears are bound to a beam emitting in the direction he's firing. +0.5 Tears, +5.25 Range, +0.16 Shot Speed. +1 Fire Rate, +2.5 Range, +0.16 Shot Speed.
The Wiz	5.100.358	1	Grants spectral tears. Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U a Wizard? pill.
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	+0.3 tears. Adds a chance to fire a razor blade that deals 4× Isaac's damage.
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 contact damage and fires a tear every 2 seconds. Spawns an orbital familiar that deals contact damage, blocks shots, and fires tears at enemies in its line of sight.
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 Heart Containers with 6 empty Bone Hearts. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a fire rate 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. Isaac gains +0.5 Speed while camouflaged, and gains Tears and Damage upon breaking it.
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 releases a gas cloud that poisons nearby enemies. Affected enemies will also release gas upon death, spreading the effect.
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 luck-based 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	+7 Bombs. Removes the delay between bomb placements, allowing them to be placed rapidly. Bombs will no longer knock each other away.
Finger!	5.100.467	1	Spawns a finger familiar that faces in the same direction as Isaac, rapidly damaging enemies it points at for 10% of Isaac's 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	Turns Isaac's tears into large blood tears 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. The aura also increases damage by 20% and gives homing.
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. When stationary, Hushy will periodically fire out rings of projectiles.
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	Taking damage grants a body part orbital that blocks shots and deals contact damage, up to a maximum of three. The body parts are destroyed after blocking enough damage.
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. The cloud will gradually increase in size, while the damage it does gradually decreases.
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 hatches a random friendly monster when Isaac is hurt once per room. The power of the monster improves for each consecutive room cleared without taking damage.
Parasitoid	5.100.461	1	Adds a chance to fire an egg sack which creates slowing creep and spawns 1-2 Blue Flies or Blue Spiders 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 and open doors.
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 ×0.3 damage multiplier. Each tear is given a random effect that alters its movement.
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. Dealing enough damage to 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 Fire Rate 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 fewer 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 Minisaac familiars 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. Affected enemies are cursed and take more damage from Brimstone-like attacks.
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 fire rate for the current room when Isaac takes damage. Isaac's tears also leave pools of red creep for the rest of the room.
Keeper's Kin	5.100.717	1	Rocks and other Obstacles 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	Spawns a Dumpy familiar that pushes away nearby enemies and projectiles just before Isaac is about to be hit, then falls asleep. He can be awoken by walking to him.
Lil Portal	5.100.681	1	Spawns a familiar that flies forward, consuming pickups in its path and dealing damage to enemies. Each pickup increases its size and damage and spawns a Blue Fly. Every 4 pickups, opens a portal that leads to an unexplored room. After `1 + (stage number)` pickups, opens a portal which leads to a special room with contents that persist between floors.
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	+5 Bombs. Each bomb gains 1-4 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 seeks out incoming enemy shots and destroys them.
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 with the Bait status effect. Enemies marked as bait 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.