| Name |
Icon |
Flavor Text |
Effect |
Quality
|
| Arrow of Light
|
|
Ascend to boyhood
|
- +0.5 Shotspeed.
- +0.25 Tears.
- Increases knockback.
- Grants piercing in darkness.
|
3  
|
| Axolotl
|
|
I amn just a litle creacher
|
- Grants a shooting familiar that can block enemy projectiles.
- After blocking 3 projectiles, it spawns 3 Blue Flies and dies.
- While dead, it can no longer attack or block projectiles, but will periodically spawn more Blue Flies.
- Regenerates when changing room.
|
2
|
| Azazel's Horn
|
|
Zealous black hearts
|
- +1 Black Heart.
- Black Hearts will now trigger their mass room damage effect whenever any amount of them is lost, instead of only when whole hearts are lost.
|
3
|
| Bad Apple
|
|
It only takes one
|
- +0.6 Tears.
- Chance to fire a tear that converts all other tears in the room into bad applies which deal half damage.
|
2
|
| Baptismal Shell
|
|
Born of water and spirit
|
- Chance for tears to transform enemies into a weaker variant of themselves based on a pre-defined evolution tree.
|
2
|
| Bar of Soap
|
|
Wash away your impurities
|
- +1 Heart Container.
- Grants a Soul Heart at the start of each floor.
|
2
|
| Baron Fly
|
|
Can't swallow its pride
|
- Orbital familiar that fires a barrage of tears at the closest enemy after blocking 5 projectiles.
|
2
|
| Bedbug
|
|
Sleep tight
|
- Orbital familiar that remains stationary relative to Isaac.
- Briefly orbits around Isaac after blocking a projectile.
|
1
|
| Blood of Satan
|
|
The soul atones for blood
|
- +0.66 Damage.
- Fully heals all Heart Containers.
- Will always cost 1 Soul Heart if found as a Devil Deal item.
|
1
|
| Bob's Heart
|
|
Volatile friend
|
- Grants two trailing familiars.
- Bob's Intestine: Trails closer to Isaac and inflicts poison to enemies it comes into contact with.
- Bob's Heart: Trails further from Isaac and explodes on contact with enemies.
|
0
|
| Bucket of Blood
|
|
Health up, mixed blood
|
- +3 Heart Containers.
- Rerolls all of Isaac's health into a random assortment of filled Heart Containers, Soul Hearts, and Black Hearts.
|
2
|
| Cactus
|
|
Peashy keen
|
- Spawns a stationary familiar in a random position each room that deals contact damage to enemies.
- Blocks Isaac's tears and enemy projectiles; after blocking 5 shots in total it bursts into a small shower of tears and a ring of tacs.
- After bursting, regenerates after a few seconds.
|
1
|
| Caduceus
|
|
Equalized healing
|
- Transforms all full Red Heart and full Soul Heart pickups into Blended Hearts.
|
4
|
| Cataract
|
|
Cloudy vision
|
- Increases tear size.
- Tears decelerate until they stop moving entirely.
- Tears remain in the air for a longer time.
|
2
|
| Chastity Belt
|
|
Your body is a temple
|
- +2 Damage.
- The given damage up will be decreased depending on how many keys you have.
- Key pickups disappear after leaving and re-entering the room they are located in.
|
2
|
| Celestial Berry
|
|
Feather away
|
- When entering an uncleared room for the first time, a winged berry will appear in a random position.
- Picking up the berry grants:
- +1 Damage, +0.5 Tears, and flight for the room.
- +0.05 Luck permanently.
- The berry will fly away if not picked up within 3 seconds.
|
3
|
| Chimerism
|
|
I art I
|
- +2 Heart Containers.
- +2 Damage.
- 2 bombs are placed at once for no extra cost.
|
3
|
| Cholera
|
|
Crappy aim
|
- +1 Luck.
- Chance to fire a brown tear that transforms enemies into Poop.
- Chance scales with Luck.
- Brown tears are fired at slightly wonky angles.
|
3
|
| Chunk of Tofu
|
|
Packed with phytoestrogens
|
- Cube of Meat-style progressive familiar.
- Replaces all items in Boss Rooms with more Chunks of Tofu.
|
2
|
| Coil
|
|
Coiling orbital
|
- Orbital familiar that briefly moves further away from Isaac after blocking a projectile.
- After blocking a shot, it slowly difts back towards Isaac.
|
2
|
| Cootie
|
|
Ew, gross!
|
- Familiar that charms the non-boss enemy in the room with the highest health.
|
3
|
| Cracked Infamy
|
|
Damage reduction... ?
|
- 2.5% chance to trigger the
 Glowing Hourglass effect when taking damage.
- Each time Isaac takes damage and the effect does not trigger, the chance increases by an additional 2.5% up to a maximum of 20%.
- The effect cannot trigger when fighting a boss that grants a completion mark.
|
1
|
| Cyst
|
|
First strike!
|
- 10x Damage Multiplier until after the first time Isaac fires in each room.
- If 5 seconds pass Isaac will lose the damage boost automatically.
|
3
|
| Dead Lung
|
|
Coughing up blood
|
- +1 Black Heart.
- Isaac creates a pool of red creep when taking damage.
|
1
|
| Defibrillator
|
|
Starting to see black
|
- 1.5x Damage Multiplier in alternating rooms.
|
2
|
| Effigy
|
|
See them burn
|
- When entering an uncleared room, grants a 15% chance to replace all enemies with Burning Effigies.
- Effigies are completely harmless and have no hitbox, but can be bombed for a chance to spawn a random wooden pickup.
|
3
|
| Empiric
|
|
Quack medicine
|
- Causes all Pills to be permanently unidentified.
- Converts all Pills into Horse Pills.
- Naturally spawned Horse Pills are converted into Whale Pills instead.
|
3
|
| Eternal Bombs
|
|
Cast the beast into a lake of fire
|
- +5 Bombs.
- Bombs deal double damage to bosses.
|
3
|
| Eve's Nail Polish
|
|
Every shot counts
|
- Landing a tear on an enemy reduces the time until Isaac can fire his next shot.
|
2
|
| Forbidden Fruit
|
|
Damage up?
|
- 0.65x Damage Multiplier, then grants +5 flat Damage.
|
2
|
| F.O.P.
|
|
Unbreakable
|
- Spawns a Bone Heart on pickup.
- If Isaac would take fatal damage, it is prevented and all of his Heart Containers are replaced with empty Bone Hearts.
- This can be repeated infinitely so long as Isaac has Heart Containers to convert.
|
3
|
| Frail Fly
|
|
He's weak
|
- Orbital familiar that deals heavy contact damage and blocks enemy projectiles, but dies after blocking 3 shots.
- Respawns when entering another room.
|
1
|
| Friendly Monster
|
|
Lost in orbit
|
- Orbital famliar that orbits a random enemy in the room, while shooting spectral tears in the same direction as Isaac.
|
2
|
| Guppy's Pride
|
|
What's up with that?
|
- Grants a shooting familiar on pickup and at the start of every new floor.
- The familiars' tear damage scales with Isaac's Damage.
|
2
|
| Heart Shaped Balloon
|
|
Pretty balloon
|
- Grants a trailing balloon familiar.
- For every cleared room, the familiar will change colors to resemble a specific heart pickup.
- Taking damage pops the balloon and spawns the respective heart on the ground.
- The balloon will regenerate back to its first form upon entering the next room.
- If the balloon resembles an Eternal Heart, it will pop automatically after clearing another room.
|
4
|
| Hundred Dollar Steak
|
|
Don't swallow in one bite
|
- Grants a Heart Container every 30 minutes.
|
1
|
| Hyperopia
|
|
Hyper tears
|
- +0.3 Tears.
- Tears accelerate as they travel, gaining piercing once they reach high enough speed.
|
2
|
| Joyful
|
|
You feel nothing
|
- Grants a chance to gain a 2x Damage Multiplier for the room when taking damage.
- In the following room, grants a 0.85x Damage Multiplier.
- 35% chance for a Joy Pill to drop on room clear, alongside normal rewards.
|
2
|
| Kapala
|
|
Shared blood
|
- 1.5x Damage Multiplier.
- Damage dealt to enemies is split evenly amongst all other enemies of the same Type and Variant.
|
4
|
| Laughing Gas
|
|
Winners don't use drugs
|
- +0.3 Shot Speed.
- -1 Fire Delay.
|
2
|
| Lemon Head
|
|
Tears up, pucker up
|
- +0.8 Tears.
- +2.5 Range.
- Reduces tear size.
|
2
|
| Lent
|
|
Abstainence...
|
- Not picking up hearts for a floor will grant full health and +0.5 Damage at the start of the next floor.
|
1
|
| Mad Onion
|
|
So pungent, so divine
|
- Grants a chance to fire a tear that deals 3.2x damage but possesses no tear effects.
|
2
|
| Mark of Cain
|
|
Wear it with shame
|
- After 10 seconds of being in a non-special room, all doors will open.
- Taking damage from an enemy deals 7x your Damage to them.
|
2
|
| Milk Teeth
|
|
Delayed splinter shot
|
- 0.5x Tears Multiplier
- Tears split into a spread of 5 blood shots after travelling far enough from Isaac.
|
3
|
| Moxie's Head
|
|
Damage multiplier
|
|
3
|
| Mustard Seed
|
|
Plant your faith
|
- +1 Heart Container.
- +1 Luck.
- Grants a chance to fire a seed tear that inflicts enemies with Germinated.
|
3
|
| Old Bell
|
|
Damage up, its ring dulls
|
- +3 Damage.
- The given Damage is reduced by 0.6 at the start of every floor until it reaches 0.
|
3
|
| Peashy
|
|
Are you Cereus?
|
- +1 Heart Container.
- +0.5 Damage.
|
2
|
| Philosopher's Stone
|
|
Health of wealth
|
- +1 Heart Container.
- +3 Gold Hearts.
|
1
|
| Photon
|
|
Shotspeed way up
|
- +1 Damage.
- +0.35 Tears.
- Tears hit enemies immediately after being fired.
- Tears no longer have knocback.
|
3
|
| Rapture
|
|
Twisted tale, thousand eyes, trapped forever
|
- Decreases the size of enemy projectiles.
- Any projectiles fired by an enemy are destroyed upon that enemy's death.
|
2
|
| Reflux
|
|
Can't hold it in...
|
- 0.5x Tears Multiplier.
- While holding the fire buttons, tears will start to boil shortly after being fired.
- Releasing the fire buttons causes all boiling tears to explode.
- The explosions cannot hurt Isaac.
|
3
|
| Rewards Card
|
|
Repeat customer discount
|
- +1 Gold Heart.
- Each time you collect a purchasable item or pickup, all purchasables on the floor have their price reduced by 1.
- Price reductions are reset at the start of a new floor.
|
3
|
| Rickets
|
|
Brittle bones
|
- +1 Damage.
- Greatly increases knockback from Isaac's tears but firing tears knocks Isaac back as well.
|
1
|
| Roll Film
|
|
Choose your fate
|
- Drops the
 Faded Polaroid trinket.
- When at three hearts or below, all damage is reduced to half of a heart.
- The on-damage effects of
 The Polaroid and  The Negative now trigger at three hearts or below.
|
2
|
| Salesman's Eye
|
|
What an anomaly
|
- Grants a random discount to items in the shop
- Discounts range from 0-4 coins.
|
1
|
| Silver Charm
|
|
Blue blood
|
- +2 Soul Hearts.
- On pickup, converts all Heart Containers into Soul Hearts at a 1:3 ratio.
- Will not convert more Heart Containers if Isaac's health bar has been completely filled.
|
2
|
| Silver Flesh
|
|
What a peculiar object...
|
- Grants a chance to fire a ring tear that deals 1.5x damage.
- If the ring kills an enemy, it has a high chance to drop a Half Soul Heart.
|
3
|
| Slick Spade
|
|
Concupiscent hatred
|
- Grants a 10% chance to fire a random Playing Card themed tear. The suit type determines its effect:
- Hearts - Charming.
- Diamonds -
 Midas' Touch freeze.
- Spades - Fear.
- Clubs - Bleeding.
- Using a Playing Card will apply the effect of its suit's tear to every enemy in the room.
|
2
|
| Sloth's Toe
|
|
Merit of idleness
|
- -0.1 Speed.
- Standing still for a second and a half grants +2 Damage and +0.8 Tears until Isaac moves again.
|
1
|
| Smooth Stone
|
|
Strike down those who tower above
|
- +0.5 Damage.
- Bosses and enemies with 150 or more maximum health take 1.5x damage from all sources.
|
3
|
| Snake Oil
|
|
Damage up!
|
- Significantly increases tear size.
|
1
|
| Soap Box
|
|
A reliable platform
|
- +2 Range.
- Heals for 2 hearts at the start of each floor.
|
1
|
| Some Options
|
|
Decisions, decisions
|
- 20% of pickups spawn alongside a random wooden pickup.
- Taking the original pickup will cause the wooden one to disappear and vice versa.
|
3
|
| Soy Bean
|
|
Gaseous shot
|
- Grants a chance to fire a tear that activates a
 Butter Bean fart on hit.
- Monsters directly hit by these tears leave a
 Linger Bean cloud on death.
- Chance to fire the special tears scales with Luck.
|
2
|
| Sucker Sac
|
|
Blood-borne disease
|
- Blue Flies create poisonous farts when damaging enemies.
- Spawns 1-3 Blue Flies for every red heart regained.
|
3
|
| Sunken Fly
|
|
Prone to bloating
|
- Orbital familiar that inflates when touching an enemy or Troll Bomb and attempts to push them away.
|
2
|
| Mom's Suppository
|
|
Damage up?
|
- -2 Damage, then applies a 1.5x Damage Multiplier.
- Spawns 1-3 Pills on pickup.
|
3
|
| The Sign
|
|
DMG up?
|
- Sets Isaac's Damage to 7, ignoring any damage up effects granted before picking up the item.
- The damage is set before being affected by Damage Multipliers.
- Damage up effects granted after picking up the item are not affected.
|
2
|
| Tithe
|
|
Your heart is with your treasure
|
- +1 Eternal Heart.
- When entering a new floor: removes Isaac's coins, bombs, and keys randomly until they have 10 coins, 1 bomb and 1 key or less.
- For each pickup lost in this way, there's a 3% chance of teleporting to the Angel Room and halting the process of removing the pickups.
|
2
|
| Tool
|
|
Remember being born?
|
- When damaging enemies, grants a chance to deal that damage to all other enemies of the same Type and Variant in the room.
- The chance scales with Luck.
|
3
|
| Toy Drum
|
|
Your heart beats hard
|
- Every two seconds, Isaac's damage is doubled for half a second.
|
3
|
| Vanilla Wafer
|
|
Damage compensation
|
- For every full Red Heart lost in an uncleared room, half a heart is refunded upon room clear.
|
2
|
| Wax Wing
|
|
Don't fly too high
|
- +0.6 Tears.
- +0.3 Speed.
- +2 Luck.
- 1.35x Damage Multiplier.
- Grants flight.
- All of the above bonuses are removed upon taking damage and Isaac is teleported to the starting room of the floor.
- The bonuses are regained upon entering the a new floor.
- While in a boss room, Isaac is instead teleported to the entry door and the fight is not interrupted
|
3
|
| Weltling Sac
|
|
Blood explosions
|
- +5 Bombs.
- Bombs summon a ring of blood explosions around themselves when exploding.
- The blood explosions deal damage to enemies and destroy their projectiles.
|
2
|
| Booster Shot
|
|
Compounding tears
|
- -0.5 Damage.
- Grants piercing.
- The damage of Isaac's tears is increased by 1.5x for every enemy they pierce.
|
3
|
| Carapace
|
|
Exoskeleton
|
- +1 Damage.
- 0.75x Speed Multiplier.
- The first instance of damage Isaac takes each is negated and the above changes are removed until Isaac enters another room.
|
4
|
| Eye of Balor
|
|
Dominate and destroy
|
- The enemy with the lowest percentage health, that is not at full health, will take 1.5x damage from all sources.
|
3
|
| Glioma
|
|
Say that again
|
- +0.3 Tears.
- Grants a 15% chance to fire a concussive tear.
- Upon defeating the floor's boss, all regular cleared rooms become uncompleted and can be re-beaten for additional rewards.
|
3
|
| Ham
|
|
Long pork
|
- +1 Heart Container.
- +2 Black Hearts.
- +0.75 Damage.
- +3.5 Range.
|
3
|
| Spoils Pouch
|
|
Blood money
|
- Enemies have a chance to drop a spinning coin upon death.
- The chance scales with Luck, the enemy's maximum health and the current stage.
- The coin can be a Penny, a Nickel or a Dim, using the default coin spawn rules.
- If the coin spins for 2 seconds or if the room is left and then re-entered, the coin disappears.
|
3
|
| Technology Omicron
|
|
Laser aura tears
|
- 0.8x Tears Multiplier.
- Tears gain a small Tech X laser ring around them.
|
3
|
| Friend Folio
|
|
Rival chapter
|
- Grants a random Retribution familiar that changes every room.
- May grant a Friend familiar unique to this item.
- Friend walks around the room targeting enemies like a level 4
 Cube of Meat.
- Friend periodically fires fire tears at her target.
|
2
|
| Beeconomy
|
|
Economic colony collapse
|
- +30 coins.
- Will always cost 15 coins.
- Spawns 3 Melitodes Bees upon pickup and when entering a new room.
- This effect stops working after another item is purchased.
|
2
|
| Bell Clapper
|
|
Damage up, it's a dull ringer
|
- +0.3 Tears.
- +1.5 Damage.
- The damage bonus given by this item is multiplied by 0.9 for every tear fired in the same room.
- Damage bonus reductions are negated when entering a new room.
|
3
|
| Brownie
|
|
Damage up, your bowels rumble
|
- +1.5 Damage.
- While in uncleared rooms, Isaac will occasionally summon a friendly Corn Mine and leave a trail of brown, slippery creep for a few seconds.
|
2
|
| Brunch
|
|
HP up
|
|
1
|
| Conjunctivitis
|
|
Eye sack
|
- -1 Fire Delay.
- Isaac's tears now leave puddles of slowing creep.
|
2
|
| Milk of Baphomet
|
|
HP up, random on-hit effects
|
- +1 Heart Container.
- Taking damage triggers a random on-damage effect.
|
2
|
| Devil's Tooth
|
|
Exsanguinating tears
|
- Grants a chance to fire a tear that upgrades the hit enemy into a stronger version of itself.
- If the enemy is successfully transformed, its current health is halved.
- Chance scales with Luck.
|
2
|
| Impact Wax
|
|
Did you say something?
|
- +0.5 Damage.
- While shooting, short-ranged tears that leave puddles of slowing creep and deal 0.75x of Isaac's damage are fired from the sides.
|
3
|
| Bootlicker
|
|
It hurts so good
|
- +1 empty Heart Container.
- +0.25 Damage permanently for each time Isaac takes damage between gaining the item and killing a floor boss.
- Prevents Isaac from picking up hearts of any type until a floor's boss is killed.
|
2
|
| Melitodes
|
|
Honeyed one
|
- Grants a chance to fire a tear that creates a Melitodes Bee when hitting an enemy.
- The chance scales with Luck.
|
2
|
| Myopia
|
|
Phasing tears
|
- +0.2 Shot Speed.
- +0.3 Tears.
- Tears turn transparent as they travel, eventually gaining spectral and homing.
|
3
|
| Sculpted Soapstone
|
|
Health up... and up...
|
- +1 Soul Heart.
- Grants a filled Heart Container at the start of every floor.
|
3
|
| Sour Patch
|
|
Bitter damage
|
- +1.2 Damage.
- +0.15 Shot Speed.
- Tear size down.
|
3
|
| Swindler
|
|
He's a keeper
|
- Familiar that attempts to pick up pickups around the room.
- Will always collect coins, and will only collect keys and bombs outside of Isaac's reach.
- Uses his pickups to open any chests in the room.
- When completing a room, may spawn a shop item, granting a discount based on the number of coins he has collected.
|
2
|
| Multi-Capsule
|
|
Three pulls in one!
|
- Spawns 3 random Capsules.
|
2
|
| Kompu Gacha
|
|
Capitalism at its swinest
|
- Spawns a random Capsule, then, for every 5 coins Isaac currently holds:
- Spawns another random Capsule.
- Removes 5 coins.
- Capped at spawning 10 Capules.
|
2
|
| Heel Spur
|
|
Speed = DMG
|
- +1 Bone Heart.
- Applies a Damage Multiplier that scales with how fast Isaac is moving.
|
3
|
| Bandage Binder
|
|
Please bind responsibly
|
- +2 Range.
- +0.4 Damage.
- Spawns 1-3 bone orbitals when taking damage.
|
2
|
| Sinner's Prayer
|
|
You died for my sins
|
- +1.4 Damage.
- Chance to summon a pillar of
 Holy Light onto enemies that hurt Isaac.
- 25% to survive any fatal damage.
- Surviving fatal damage will also summon a pillar of Holy Light onto what hurt Isaac.
|
3
|
| Heartbroker
|
|
Blood money
|
- +1 Gold Heart.
- +2 Broken Hearts.
- Broken Hearts can now be used to purchase Devil Deals.
|
2
|
| Jet Feather
|
|
Fall
|
- Angel Deals no longer vanish when another item is taken, but will cost health to purchase.
- Devil Deals no longer cost health to purchase, but will vanish if another item is taken.
|
2
|
| Derelict Anchor
|
|
Shipwrecked
|
- Enemies are bound to an anchor that restricts their movement speed.
- The anchor can break rocks it's dragged through.
- The anchor will be destroyed if its host becomes intangible or it is dragged over a pit.
|
3
|
| Red Chain
|
|
Shackled without restraint
|
- +3 Keys.
- Roughly 33% chance to spawn a Red Pillar when entering a new room.
- Red Pillars can be unlocked with a key to spawn a portal to a random new
 Red Key room.
|
3
|
| Dominicus
|
|
Long-lost natal sun
|
- Grants 3 orbital familiars that cycle through 9 variants in a set order.
- The familiars are launched in the direction Isaac is firing when they align with his line-of-sight, each with a unique effect.
- Dominicus familiars break after hitting a wall and will be replaced with the next variant after a couple of seconds.
|
3
|
| Heart Rupture
|
|
Bursting hearts!
|
- Enemies have a chance to launch a heart pickup into the air upon dying.
- The chance scales with Luck, the enemy's maximum health and the current stage.
- Catching the heart will heal Isaac.
- Missing the heart will cause it to splatter on the ground and spawn playe-controlled creep.
|
2
|
| Pride Pin
|
|
Kinsey tears
|
- Tears cycle through a set of Retribution tear effets.
- A new effect is chosen every 5 seconds.
|
4
|
| Hemorrhoid
|
|
Charged blood blast
|
- Charges up a
 Monstro's Lung style tear volley while firing.
- Releasing the firing buttons fires the tear volley opposite to the direction Isaac is moving.
- Taking damage spawns a Red Poop.
|
2
|
| Polaris
|
|
Mark of the nothern star
|
- Killing enemies without taking damage upgrades Isaac's attacks:
- Levels are mutually exclusive and are reset when taking damage.
|
3
|
| Bag of Seeds
|
|
Bountiful harvest
|
- Periodically spawns Pullroot saplings around the room.
|
3
|
| Baby's Breath
|
|
Belittling death rattle
|
- On death, enemies Baptismally downgrade other nearby enemies.
- Downgrading radius scales with the enemy's maximum health.
|
2
|
| Bleeding Heart
|
|
Charming exsanguination
|
- +1 Heart Container.
- Chance to fire a pink tear that inflicts Charm.
- Charmed enemies now fire Isaac's tears in random directions.
- Charmed enemies now charm other nearby enemies on death.
- Charming radius scales with the enemy's maximum health.
|
3
|
| Gloriosa
|
|
Blazing tears
|
- 0.75x Tears Multiplier.
- Tears travel in an arc and leave behind a fire jet when colliding.
- Tears inflict Burn to enemies on direct hits.
|
3
|
| Corpse Flower
|
|
Gangrenous tears
|
- Spawns a Rotten Heart on pickup.
- Chance to fire a green tear that inflicts a long-lasting but weak Poison.
- Poisoned enemies now periodically spawn a Blue Fly.
- These Blue Flies will not target the enemy that spawned them.
|
3
|
