It also changes tears to a chargeable laser that pierces all objects in its path (including enemies, environmental hazards and walls). UNLOCK: Unlock this card by opening Mom's Box on the Home floor. pill if no other pills were used yet. Based on the Steam Workshop mod created by Jean-Alphonse, UNLOCK: Unlock this item by opening 20 locked chests, *, mr me!, Mr Meeseeks, rick and morty, brown, chest, szechuan sauce, mister me, Grants a prism orbital with a large orbital radius, Isaac's tears that pass through the prism split into four multi-colored tears, Does not deal contact damage to enemies that it passes over, Added as part of the Afterbirth+ Booster Pack #3. The laser hits up to 13 times if an enemy stays inside it for the duration, Has a chance to drop from the Envy and Super Envy miniboss fights, Item Pool: Item Room, Envy Miniboss, Super Envy Miniboss, * item room, treasure room, item room pool, red, lips, white, eyes, UNLOCK: Unlock this item by beating the Basement 40 times and defeating the Steven boss, *, black, white, face, eyes, mouth, golden chest pool, +10% chance of a devil/angel room opening while held, A second Pentagram will give an extra +5% chance, Counts as 1 of 3 evil items needed towards the Leviathan transformation, Item Pool: Boss Room, Curse Room, Devil Room, Demon Beggar, Crane Game, * curse room pool, devil pool, devil room pool, devil deal, boss room pool, boss room item, You still take damage however when using Blood Donation machines and Devil Beggars, *, spikes, spikey, spike rock, greyhost, grey host, Causes all pedestal items to show up as rotating items, that swap every 1 second between the original spawned item and a HP up item. Most items that change tear color will also give Brimstone an exotic appearance, but they do not combine and only one color effect is shown. Dessert = +1 Flat Damage, +0.2 shot speed. Activates a random rune effect. Can be negated with Black Candle, Bad Gas - Isaac farts, poisoning enemies around him, Bombs are key - Switches number of bombs and keys, Explosive Diarrhea - Spawns five live troll bombs behind Isaac, one per second, Full Health - Restores all your empty red heart containers, Health Down - -1 HP. Isaac's tears are replaced with a charged blood laser beam. While you have this flame you also have that item's effect, The flame deals double your tear damage to any enemies that touch it, but if it takes too much damage the flame will disappear and you lose the item's effect, Wisps are randomly chosen from Item Room, Boss Room and Shop item pools, with a 25% chance to pick the same pool as the current room. Charge time increased to 4 (from 2), UNLOCK: Unlock this item by dying 100 times, * item room, treasure room, item room pool, grey, gray, Holding the active item button will deplete the charge bar. lightning, bolt, hot garbage, Tears now have a bigger knockback effect, which pushes enemies backwards, * astrology, astronomy, item room, treasure room, item room pool, h, blue, glow, Tears Down by exactly half (Tear delay * 2), The tears down from this item is a x2.0 multiplier after the formula, meaning it will always halve your tear rate (Unless you have Monstro's Lung or Soy Milk), UNLOCK: Unlock this item by beating Boss Rush with Eve, * item room, treasure room, item room pool, makeup, make up, black, grey, gray, square, eves mascara, When you die with this item, you respawn in the previous room as Dark Judas with 2 black hearts for health, Dark Judas has a damage multiplier of 2.00 (double Isaac's damage) and an additional +0.1 Speed, Dark Judas is considered a separate character by the game, however he can be used to unlock Judas' secrets/achievements, REPENTANCE - Dark Judas can no longer gain red heart containers, HP upgrades give soul hearts instead, UNLOCK: Unlock this item by beating Boss Rush with Judas, * devil pool, devil room pool, devil deal, item room, treasure room, item room pool judas shadow, All future red hearts now heal for double. Abel, UNLOCK: Unlock this trinket by defeating Isaac, ?? The more you spend the higher the stat increase, Possible stats include Speed, Damage and Range, 15c items give all 3 stats: +1 Damage Up, +0.03 or +0.06 Speed Up, +0.25 or +0.5 Range Up, 5c items give 1 or 2 stats: +0.5 Damage Up **OR** +0.25 Range and +0.03 Speed Up, UNLOCK: Unlock this item by defeating Mother as The Keeper, While in a room with enemies, blue spiders will randomly spawn from objects in the room (e.g. you could find a caves boss in the basement. A familiar baby that fires tears which have a chance to freeze or petrify enemies, Counts as 1 of 3 familiar items needed towards the Conjoined transformation, When used, rerolls all items in the room into another random item from the current room's item pool, however the item also has a 30% chance to disappear, The chance associated with this item does NOT scale with your Luck stat - it's always 30%, In the game files this item is called 'Florians Dice', which is a reference to the Eternal update for the original Binding of Isaac game, which changed the D6 to act as this item does. It can be anything including spawning a bunch of consumables, spawning a glitched pedestal item, creating a bunch of light beams, spawning troll bombs or nothing at all, UNLOCK: Unlock this item by defeating The Beast as Eden, "Isaac and his mother lived alone in a small house on a hill", When picked up, all future items become 'glitched', causing them to become random combinations of 2-3 effects based on other items, Glitched items can be passive or active and are completely randomly generated with infinite possibilities (similar to other 'Randomizer' games), The ratio of active to passive item effects given is 1/4, Random effects combine effects that exist on other items, and assign them to a random event (e.g. syringe, needle, injection, purple, grey, gray, Causes Isaac to shrink in size (including hitbox slightly), Can be dropped when exploding mushrooms in the environment that are usually found in the Caves/Catacombs and in secret rooms, * item room, treasure room, item room pool, mushroom, blue, spotted, Adds several instances of The Bible item into all item pools. grey, gray, lamp, UNLOCK: Unlock this item by making a Super Bandage Girl, * boss room pool, boss room item, pink, plaster, sticker, item room, treasure room, item room pool, the lost item pool, When used Isaac transforms into pacman, which makes him invincible for 6 seconds and does 40 contact damage to enemies per chomp, Everytime you 'eat' 2 enemies, you regain 1/2 heart of red health, You can't shoot tears while the effect is active, UNLOCK: Unlock this item by visiting 10 arcades, * item room, treasure room, item room pool, gameboy, grey, gray, white, A bag that floats around following Isaac and drops a random coin every 2 rooms, UNLOCK: Unlock this item by beating Isaac with Cain, * secret room pool, item room, treasure room, item room pool, bag, purple, pouch, A familiar which follows Isaac and shoots lasers, similar to the Technology item, Robo-Baby's laser is spectral and piercing (It will pass through rocks and objects in the environment), Robo-Baby's lasers deal 3.5 damage per hit, * item room, treasure room, item room pool, robo baby, robot baby, white, grey, gray, silver, red, A familiar which follows Isaac and drops half a red heart every 3 rooms, UNLOCK: Unlock this item by beating the Caves 30 times and defeating C.H.A.D, * lil chad, little chad, item room, treasure room, item room pool, the lost item pool, red, smile, face, bug, Any pickups are possible from this item, including Bombs, hearts, keys, coins, pills, batteries, tarot cards, runes etc, Doesn't produce microbatteries, only regular sized ones and rarely golden/mega batteries, UNLOCK: Unlock this item by beating each of the Seven Sins once, Item Pool: Item Room, Library, Devil Room, * library pool, library room, book room pool, devil pool, devil room pool, devil deal, item room, treasure room, item room pool, red 7 book, grey, gray, black, A blue cross that follows Isaac and drops a soul heart every 7-8 rooms, REPENTANCE - The Relic now generates soul hearts less frequently, UNLOCK: Unlock this item by beating the Isaac boss with Maggy, * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, * e coli, item room, treasure room, item room pool, tampon, bloody, red, white, red sperm, ecoli, Isaac's tears turn into large scythes that pierce through enemies (Similar to how Death's scythes look), UNLOCK: Unlock this item by beating Challenge #17 (Waka Waka), * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, axe, silver, The achievement 'Sumptorium' is unlocked by defeating Delirium as Tainted Eve, When used, this will retreive the Tainted Forgotten's skeleton back to its owner's hands from any distance, Tainted Forgotten's Birthright effect. Does not prevent Isaac from taking contact damage, All the above effects are only active when the item is used for the current room. golden, yellow, glow, A familiar that follows Isaac and blocks any shots that hit it, If a projectile is blocked by Dry Baby, he has a 10% chance to activate the Necronomicon effect, dealing 40 damage to the entire room, The chance to activate the effect is not changed by your Luck stat, * item room, treasure room, item room pool, dry baby is best baby, northernlion, fat skeleton, Depths 2: 20 coins, Sheol: 1 Devil Room Item + 1 Black Heart. Haemolacria's appearance in the original Steam Workshop mod. Every so often it will come up and attempt to grab onto a random enemy in the room, holding them in place and dealing damage, The Worm Friend deals 4 damage for 8 ticks total, If the enemy moves quickly enough it can miss its attack, UNLOCK: Unlock this item by defeating The Beast as Apollyon, Enemies that die will leave behind 1-2 floating bone shards where they die, until you leave the room, Other enemies that touch the bone shards will take 3.5 damage, with a chance to either bounce off them or cause it to break and disappear, UNLOCK: Unlock this item by defeating Mother as The Forgotten, Each time an enemy dies, a friendly red soul appears. Tears have a 50% chance to be Blood Clot tears. Blood Clot - Unless playing as Cain, no damage or range bonus will be given from the item, as the blood clot covers the other eye. gray, horns, Tears are replaced with a knife which can be charged and thrown in a boomerang style action, The knife can also do damage without being thrown as a close range melee weapon, When used as a melee weapon, Mom's Knife deals your tear damage * 2 per tick, At the furthest point from Isaac the knife deals your tear damage * 6, UNLOCK: Unlock this item by beating Satan with Isaac, Item Pool: Item Room, Devil Room, Challenge Room, Mom's Chest, * dungeon room, blood challenge room, arena pool, devil pool, devil room pool, devil deal, item room, treasure room, item room pool, grey, gray, silver, Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. shop room pool, shop item pool, cross, brown, Upon use, gives +2 damage up which lasts for the current room, x1.5 times Damage Multiplier if you also have Blood of the Martyr (Does not stack with Magic Mushroom or Cricket's Head multipliers), Increases your chances of getting a devil/angel room by +12.5%, REPENTANCE - The effect stacks if used multiple times, * library pool, library room, book room pool, devil pool, devil room pool, devil deal, starting Manage all your favorite fandoms in one place! ?, as they cannot gain red heart containers (except for counting towards the Spun transformation), REPENTANCE - Adrenaline now grants an increasingly higher damage bonus the more empty heart containers Isaac has, * Adderline, pink, syringe, needle, injection, Isaac gains electric tears, which fire 1-2 sparks of electricty in random directions upon hitting any object or enemy, The electricity will chain between nearby enemies, The electricty deals half of your normal tear damage, Tear effects will still apply to your electricty sparks in a lot of cases. shop item pool, brown, x, cross, paper, Isaac has a random chance to fire another tear out the back of his head, The chance to fire the second tear can improve based on your luck stat and will always activate at +5 Luck, At +0 luck theres a ~50% chance for this effect to activate, Synergizes very well with a lot of items. UNLOCK: Unlock this item by defeating The Beast as ??? These damage increases do not stack with each other. (page 3, column 6, row 3)(page 2, column 6, row 6). Not to be confused with Blood Clot, an item. Counts as 1 of 3 angel items needed towards the Seraphim transformation. Achievements This room isn't part of the actual floor, and leaving it returns you to where you teleported from, The boss isn't necessarily from the current floor - e.g. Pickups However after the attack you end up near the boss, which puts you in danger of taking damage too, Scales in damage and area of effect with the player's size, UNLOCK: Unlock this item by defeating Delirium as Jacob & Esau, When used will do a swipe attack in any direction. Effects. This is decided by whatever you have the least of. You need to move out of the way or it will hurt Isaac, but can be used to open anything requiring a bomb e.g. Items: Inner Eye, Almond Milk, Brimstone, Pentagram, Brain Worm. Dead Bird) then Box of Friends will cause it to spawn but won't create duplicates, This can be used multiple times in the same room to generate more familiars, meaning you can get a level 4 meatboy or bandage girl by using this item 3 times in the same room, If used when you have no familiars, it will give you a Demon Baby temporarily, UNLOCK: Unlock this item by beating Greed Mode with Lilith, Isaac wears a dunce hat and fires 2 tears at once diagonally, similar to the R U A WIZARD pill tear pattern, * Item Room, Greed Mode Item Room, dunce cap, white, hat, cone, Replaces Isaac's tears with nails, which have increased knockback, The increased knockback will also affect Brimstone, which usually has no knockback at all, Gives you a familiar demon incubus that follows you and shoots tears that scale with your own tears in terms of damage, stats and also effects, It will mimic any tear effects you currently have and also copy your current stats, meaning it will fire with the same damage, fire rate and range, Incubus' damage is reduced by 25% when playing as characters other than Lilith, UNLOCK: Unlock this item by beating Blue Womb (Hush) with Lilith, Item Pool: Devil Room, Greed Mode Devil Room, A familiar blue head that will follow Isaac and fire tears copying his tear damage and effects, This familiar is very similar to Incubus, however it only copies damage and is not affected by tears or range upgrades, UNLOCK: Unlock this item by beating Blue Womb (Hush) with ??? Based on the Steam Workshop mod created by Amethyst, UNLOCK: Unlock this item by using 5 Gulp! You may take only one of the items, before being teleported back to where you were, It's literally every item, that includes items not in item pools like Knife Pieces, UNLOCK: Unlock this item by completing every post-it note for every character, including the Tainted characters, Gives you a robot fly familar that orbits around Isaac and fires shielded tears at incoming projectiles, Deals contact damage to enemies it touches, Counts as 1 of 3 fly items needed towards the Beelzebub transformation, Item Pool: Item Room, Key Beggar, Crane Game, When used, the Meat Cleaver will split all enemies in the room into 2 smaller versions with ~40% health each, For enemies that have multiple parts to them (e.g. ?, Satan and The Lamb as Tainted Lost. Also works for opening Spiked Chests and Mimic Chests without taking damage, When used, this item restarts the game and places you back on the first floor with all your currently collected items, similar to doing a Victory Lap, Allows angel rooms to be found in the new run if a devil deal was taken in the first run, In Greed Mode and while playing as Tainted Keeper, this item costs 99 coins instead of 15. Attributes The first and second familiars spawn after 15 hits, then 30 hits for the third and fourth, Cambion Conception cannot grant more than 4 familiars in total, UNLOCK: Unlock this item by beating ??? Unlocked from the 'Sin Collector' achievement (collect every Bestiary entry), Gulp! Literature. One of the following messages may show: "Some doors require a blessing. Characters Mom's Knife: . Challenges Sales can be randomly applied just like regular shops, The ladder disappears after leaving the starting room, even if you haven't used it yet, In Antibirth this was called Jacob's Ladder, which had to be renamed as Afterbirth+ already had an item with this name, UNLOCK: Unlock this item by defeating Isaac as Jacob & Esau, Permanently shows the location of the boss room on the map, After defeating the shown boss fight, this item will activate a use of the Sun card (full heal and map reveal), fully recharge your active item, remove curses from the floor, gives +3 Damage Up and +1 Luck up for the rest of the floor, Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped), In The Void floor it shows a random boss room, which isn't necessarily Delirium's room, Adds one extra secret room and one extra super secret room to each floor. Haemolacria's appearance prior to Booster Pack #5. Following the path takes you to an abandoned mineshaft, which leads you to a pedestal with the Knife Piece. Doesn't include Curse Room doors or spiked rocks, Tears can be controlled mid-flight using the directional keys, In addition to regular tears, Isaac will sometimes fire extra spectral tears that orbit around him, Fully heals all your red heart containers, Isaac now emits a large light aura that damages nearby enemies 5 times per second while touching it, The visual effect is similar to the effect given to tears by the GodHead item, The aura deals more damage towards the center, ranging from 0.75 at max range to 4 damage when touching Isaac, In addition to normal tears, Isaac now also fires a set of 4 quadshot tears with a slowing effect, The quadshot tears deal 1.5 damage each and do not scale with your damage upgrades, Upon taking damage, you have a chance to dislodge the spider from your face. 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