Midnight Snack = +1 flat damage, +1 luck. 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. Curse of the Lost), Black Candle removes the teleportation effect of Cursed Eye, +15% chance of a devil or angel room opening after the boss fight, UNLOCK: Unlock this item by donating 150 pennies to the Shop, * curse room pool, shop room pool, shop item pool, grey, gray, Gives Isaac high damage tears with a short range, Tear size and damage falls off very fast with this item, the further the tear travels the less damage it does, Tear damage starts at triple (300%) and decreases over range to eventually be 0%, * item room, treasure room, item room pool, red, bloody, eyeball, If the total sum of all your health is at one heart after taking damage, the necronomicon effect will activate, dealing 40 damage to the entire room, REPENTANCE - Missing Page 2 now doubles all black heart and Necronomicon damage (to 80 instead of the usual 40), Item Pool: Devil Room, Demon Beggar, Secret Room, * demon beggar pool, demon judgement pool, devil beggar pool, secret room pool, devil pool, devil room pool, devil deal, the lost item pool, red, bloody, purple, paper, A yellow orbital fly that will block shots and when Isaac gets hit, will seek out the nearest enemy and attack it, If the fly is in its attacking state and there are no longer any enemies in range, it will return to Isaac and go back to being a defensive orbital, * key master pool, key beggar pool, key judgement pool, item room, treasure room, item room pool, Type: Active. Based on the Steam Workshop mod (originally called Hungry Tears) created by Echo, UNLOCK: Unlock this item by taking 10 Tears Up items or pills in the same run, Isaac's tears are replaced with piercing holy flashes of light, which travel across the room in a similar speed to regular tears, Trisagion tears deal roughly 33% of your usual tear damage, however due to the size of the holy flash it is likely to hit enemies multiple times, Trisagion tears cause no knockback on enemies and simply travel through them (piercing tears), Added as part of the Afterbirth+ Booster Pack #4. 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. At 1 charge it deals 48 damage to any enemies close to Isaac. Breakfast = +0.2 shot speed, +1.5 Range. See the Broken Shovel / Mom's Shovel items for more information on how to unlock, Rotten Hearts fill up a whole container the same as normal red hearts, or the rightmost heart if you're at full health, Every time you clear a room, you'll spawn 2 Blue Flies for each Rotten Heart you currently have, UNLOCK: Unlock this by entering the Corpse floor for the first time, Spawns 2-3 pills, black/bone hearts and/or bombs when picked up, Can spawn in place of a regular sack, including in Shops for 7c, Only one heart can spawn per sack as a maximum, UNLOCK: Unlock this by defeating Mega Satan as Tainted Judas, 48 Hour Energy - Fully recharges your active item and drops 1-2 battery pickups. blue, white, triangle, Isaac's tears become large, brown and will penetrate all objects and enemies (piercing + spectral), Despite the increase in tear size, Dead Onion does NOT increase your damage stat. Spawns another Vurp! Shows you to see the contents of chests, sacks, shopkeepers and items that will drop from fires before you destroy them, Doesn't work on tinted rocks and other obstacles (e.g. Each use also gives +0.5 Black Hearts, however this is stays between rooms unlike the other effects, Allows Isaac to deal 40 contact damage to enemies for the current room. Blood Donation machines, UNLOCK: Unlock this item by beating the Isaac boss with The Lost, * item room, treasure room, item room pool, red, isaacs heart, A familiar ghost that follows Isaac around and chases enemies close-by, damaging them for 2 contact damage and causing a fear effect, * item room, treasure room, item room pool, white, lil' haunt, A familiar beggar similar to Bum Friend that follows Isaac and collects red hearts, giving Isaac black hearts, pills, cards, runes or spiders in return, For every 1.5 red hearts he takes, he will give a reward, Reward chances: Black Heart - 40%, Card/Rune - 20%, Pill - 20%, Blue Spider - 10%, Spider 10%, Item Pool: Item Room, Devil Room, Demon Beggar, * devil pool, devil room pool, devil deal, item room, treasure room, item room pool, celebrate good times come on, the lost item pool, qt 3.14, dark bum, otp, damn it reddit, horns, grey, gray, smile, A very large orbital that moves around Isaac very slowly, blocking shots and dealing 2 contact damage per tick, Affects the speed of all other orbitals, slowing them down a lot (NOTE: This effect does not happen until you get a new orbital after Big Fan), Does not count as one of your three standard orbital slots, * item room, treasure room, item room pool, fat, brown, An adorable friendly blue spider that walks around the room laying other blue spiders which attack enemies, She can only spawn a maximum of up to 5 spiders at a time and will only do so while there are enemies in the room, REPENTANCE - Sissy Longlegs now charms enemies upon contact, * item room, treasure room, sissy longlegs item room pool, qt 3.14, dark bum, otp, damn it reddit, blue, derpface, Spawns a friendly Mulligan that walks around the room. Deflected tears turn into homing tears and fire back at enemies, dealing 2 damage. blue, glow, arrow, cross, * astrology, astronomy, item room, treasure room, item room pool, cyan, black, blue, glow, n, tail, Leaves a trail of tears on the floor behind Isaac which damages enemies that walk over it for 2 damage per tick, REPENTANCE - Aquarius now synergizes with tear effects, * astrology, astronomy, item room, treasure room, item room pool, black, blue, cyan, blue, glow, 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, UNLOCK: Unlock this item by defeating Delirium as Tainted Bethany, When used, removes half a heart of health and creates a clot familiar, Clot familiars follow Isaac's exact movements including flight, firing tears and tear effects, Holding down the swap button will cause all your clots to stay in place, Works differently as Tainted Eve - instead clots are created by firing for 2 seconds, down to a minimum of half a red heart. Unlocked from the 'Dedication' achievement (participate in 31 dailies in a row), I'm Drowsy - Slows all enemies for the rest of the current room, I'm excited!!! UNLOCK: Unlock this card by beating Challenge #12 (When Life Gives You Lemons), When used, will open all doors in the current room, similar to a one-time use of Dad's Key, UNLOCK: Unlock this card by beating Challenge #22 (Speed), When used this card will activate a use of your spacebar item for free, When used, this rune will destroy all breakable objects in the current room, such as poop, rocks, secret room entrances, UNLOCK: Unlock this card by beating Challenge #1 (Pitch Black), When used this rune will double all pickups on the floor in the room, Creates copies of pickups in the Shop which can be taken for free, even if you haven't purchased them yet, Can be used to double the number of item chests in the first room of the final Chest / Dark Room floors, Cloned chests have the same types of items as the first one, Cannot be used to clone trinkets or other Jera runes, UNLOCK: Unlock this card by beating Challenge #2 (High Brow), UNLOCK: Unlock this card by beating Challenge #3 (Head Trauma), Removes the curse which is in effect on the current floor (except Curse of the Labyrinth), Can also cure the effect of the Amnesia pill, UNLOCK: Unlock this card by beating Challenge #4 (Darkness Falls), When used, reveals the entire map including all the secret room locations and other icon rooms, UNLOCK: Unlock this card by beating Challenge #5 (The Tank), Rerolls all pedestal items in the current room (One time use of the D6), UNLOCK: Unlock this card by beating Challenge #6 (Solar System), Summons 3 blue friendly spiders and 3 blue flies, UNLOCK: Unlock this card by beating Challenge #20 (Purist), When used, gives you an invincibility effect which lasts for 20 seconds, UNLOCK: Unlock this card by beating Challenge #8 (Cat Got Your Tongue), When used, gives a random Mystic rune effect, Possible effects include: Algiz, Ansuz, Berkano, Dagaz, Ehwaz, Hagalaz, Jera, Perthro, Also has a 25% chance to spawn another Blank Rune upon use, UNLOCK: Unlock this card by beating Challenge #30 (Guardian), When used, this rune deals 40 damage to all enemies in the room and consumes all pedestal items in the room, giving you a random stat increase for each item consumed, Also consumes all pickups in the room and turns them into blue flies and spiders, UNLOCK: Unlock this item by beating Greedier mode as Apollyon. The creep deals 2 damage per tick while enemies stand in it, Lazarus' revived form (Lazarus II) respawns with this item, * item room, treasure room, item room pool, blood drop, red blood, drip, Gives Isaac a guaranteed devil or angel room on every floor that they can appear, even if you have already beaten the boss and it didn't show up originally, Taking the Goat Head (or any other item) in a Devil Deal bars you from encountering Angel Rooms naturally. UNLOCK: Unlock this item by defeating Mother in the Corpse II as Lilith, Item Pool: Item Room, Red Chest, Curse Room, During the transition between floors, this item shows you a preview of the item that will spawn in the item room, and the boss that will appear, This effect will work even if you have Curse of the Blind, but the item will still appear as a ? Type: Active. Krampus Head) can still spawn, Bible drops caused by the Rosary item are not prevented by this trinket, *, stop, red, circle, line, cross, entry, warning, Causes your familiars to stay closer to each other, Poop in the environment will now explode when destroyed, While held you have an increased chance for Black Poops to spawn, which deal damage to all enemies in the room when destroyed, Gives The Poop active item a chance to spawn a Black Poop too. Possible doors include any needing a key to open (Item Room, Shop, Alt Path doors), secret rooms and crawl spaces, Cracked Orb can also reveal the location of the red room that contains a pedestal item.