Afterbirth Plus Items (110)
Dark Princes Crown
ItemID: 442
"Loss is power"
A crown appears above your head and while at exactly 1 full red heart of health, you gain a +1.5 Range Up, +0.75 Tears Up, +0.20 Shot Speed Up and +1 Tear Height.
Any time your health changes to be not exactly 1 red heart you lose the effect
This item does nothing with The Lost
Similar to other standard 'Tears Up' (not Tear Delay) items, if you are already at the soft tear rate cap this item does not give you a tears up.
UNLOCK: Unlock this item by defeating Delirium as Azazel.
Type: Passive
Item Pool: Devil Room, Curse Room
*, red, glow
Apple!
ItemID: 443
"Trick or treat?"
Gives you a 6.66% chance to fire a razor blade which deals x4 damage.
+0.3 Tears Up.
This item also turns your tears red, but does not change your actual damage stat or the damage your normal tears do
The chance to fire a razor blade depends on your luck stat, and at +14 luck you will fire a razor blade every time
Type: Passive
Item Pool: Item Room
*, red
Lead Pencil
ItemID: 444
"Hes a bleeder!"
With every 15 tears fired, Isaac will fire a cluster of 12 tears instead of your normal tear
Causes your normal tears to fire out of one eye, which means tears will fire in a near-perfect line instead of slightly off-center.
Each of the tears in the cluster deals double damage
Type: Passive
Item Pool: Item Room
*, yellow, pen
Dog Tooth
ItemID: 445
"Bark at the moon!"
+0.3 Damage Up
+0.1 Speed Up
When entering a room connected to a Secret Room or Super Secret Room, a howling sound will play
When entering a room with a crawl space trapdoor in it, a barking sound will play
Type: Passive
Item Pool: Item Room
*, white, silver
Dead Tooth
ItemID: 446
"Halitosis"
While firing, you gain a green aura that poisons any enemies which touch it. The poison deals your tear damage per tick, for 2 ticks.
Has no effect on Lilith, as she cannot fire tears.
Type: Passive
Item Pool: Item Room
*, grey, gray, brown, face, rabbit
Linger Bean
ItemID: 447
"Crying makes me toot"
While firing tears constantly for 7.5 seconds, you spawn a poop cloud, which deals periodic damage to any enemies which come near it.
The cloud deals damage equal to your base tear damage per tick, roughly 5 times per second.
Clouds last 15 seconds before disappearing.
The cloud can be pushed slightly by firing tears at it
Type: Passive
Item Pool: Item Room, Beggar
*, pink
Shard of Glass
ItemID: 448
"Blood and guts!"
Upon taking damage, this item gives a 25% chance to drop a full red heart.
Also an additional 10% chance to gain the Anemic effect for the room (+5 range, and leave a trail of damaging red creep).
Type: Passive
Item Pool: Item Room
*, blue, triangle, pyramid
Metal Plate
ItemID: 449
"It itches..."
+1 Soul Heart
Enemy bullets have a 25% chance to be deflected back at the enemy, which will hurt them and apply the concussive status effect, causing it to be stunned for a few seconds
Type: Passive
Item Pool: Item Room
*, silver, metal, grey, gray
Eye of Greed
ItemID: 450
"Gold tears!"
Every 20th tear fired will also fire a golden coin tear at the same time. This tear turns enemies to gold for a few seconds and causes them to drop 1-4 coins if killed while golden (similar to the Midas' Touch item)
When the Midas Touch tear effect triggers, it will remove 1 coin from your current total
The golden tear deals double your tear damage
The effect can still trigger even if you have no held coins
UNLOCK: Unlock this item by defeating Greedier Mode with Keeper.
Type: Passive
Item Pool: Secret Room
*, cent, coin, silver, metal, grey, gray
Tarot Cloth
ItemID: 451
"I see the future"
Drops a random card or rune on pickup
Doubles the effect of certain tarot cards
For some cards this does not double the effect (e.g. Stars card only teleports you once). In general if a card has a number of things, that thing is doubled. e.g. Jera quadruples pickups, and Black Rune deals 80 damage instead of 40.
Type: Passive
Item Pool: Shop, Curse Room
*, purple, grey, bag
Varicose Veins
ItemID: 452
"I'm leaking..."
Every time you take damage, 10 high damage tears are fired in a circle around you (similar to the Tammy's Head effect)
Tear damage is equal to Isaac's tear damage + 25 flat damage.
Additionally, has a chance to activate the Anemic effect when taking damage for 2 seconds.
Similar to Tammy's Head, this item synergizes with a lot of items (i.e. with Brimstone it fires 10 lasers)
Type: Passive
Item Pool: Item Room
*, red, tube
Compound Fracture
ItemID: 453
"Bone tears!"
Turns your tears into bones, which shatter into 1-3 smaller bone shards upon hitting any object or enemy.
The smaller bone shards deal damage equal to half your normal tear damage.
+1.5 Range Up.
+1.0 Tear Height.
UNLOCK: Unlock this item by defeating Delirium in The Void floor with Lazarus.
Type: Passive
Item Pool: Item Room
*, bone, broken, snapped, white, bloody
Polydactyly
ItemID: 454
"Hold me!"
Allows Isaac to carry two cards, runes or pills (or any combination of these) at the same time.
Drops a random card, pill or rune on pickup
Type: Passive
Item Pool: Boss Room
*, pink
Dad's Lost Coin
ItemID: 455
"I remember this..."
+1.5 Range Up
Drops a lucky penny
UNLOCK: Unlock this item by beating Greedier Mode with The Lost.
Type: Passive
Item Pool: Boss Room, Beggar
*, silver, metal, grey, gray, omega
Moldy Bread
ItemID: 456
"Midnight snack!"
+1 Health Up
Type: Passive
Item Pool: Boss Room, Beggar
*, sandwich, toast, brown, green, bite, bitten
Cone Head
ItemID: 457
"Hard headed!"
+1 Soul Heart
Each time you take damage from any source, Cone Head has a 20% chance to prevent it from reducing your health.
Isaac flashes blue very briefly when damage is negated by this item.
Type: Passive
Item Pool: Item Room
* northernlion, nl, northern lion, ryan letourneau, egg, egg father, egg daddy, dad, BALD, northernlion's head resembles an egg much like this item, isn't that hilarious?, pink
Belly Button
ItemID: 458
"Whats in there?"
Drops one random trinket on pickup.
Gives you an extra trinket slot.
Type: Passive
Item Pool: Boss Room
*, pink, circle, cross
Sinus Infection
ItemID: 459
"Booger tears!"
Isaac's tears have a random chance to be a booger instead, which stick on to enemies and deal periodic poison damage until they die.
Each tick of poison damage is equal to your normal tear damage.
Each booger persists until the enemy is dead or 60 seconds has passed.
Type: Passive
Item Pool: Item Room
* bogey, boger, green, drop, drip, boogey,
Glaucoma
ItemID: 460
"Blind tears!"
Adds a chance to shoot a concussive tear, which will cause enemies to walk around dazed in confusion.
The daze effect is effectively permanent for normal enemies, and has a much longer duration for bosses compared to other status effects.
Makes all rooms slightly darker.
The visual effect of a Glaucoma tear is hard to notice, however it is slightly lighter than normal tears and is not a perfect circle shape.
Type: Passive
Item Pool: Item Room
*, white, circle, eye, circle
Parasitoid
ItemID: 461
"Egg tears!"
This item gives you a chance that instead of firing tears you will fire an egg sack, which slows enemies on hit and drops a pool of white slowing creep below them.
If a parasitoid shot successfully hits an enemy, a blue friendly fly or spider is spawned.
Type: Passive
Item Pool: Item Room
*, blue, fly
Eye of Belial
ItemID: 462
"Possessed tears!"
Causes your tears to become piercing, allowing them to travel through enemies.
After hitting its first enemy, each tear will double in damage and gain a homing effect.
+1.5 Range Up.
+1.0 Tear Height.
UNLOCK: Unlock this item by defeating Greedier Mode with Judas.
Type: Passive
Item Pool: Devil Room
*, red, circle
Sulfuric Acid
ItemID: 463
"Acid tears!"
+0.3 Damage Up.
Each tear has a chance to become acidic, allowing it to break rocks, pots and other breakable objects.
Acidic tears can also be used to open secret rooms.
Type: Passive
Item Pool: Item Room
*, orange, yellow, bottle, X
Glyph of Balance
ItemID: 464
"A gift from above"
+2 Soul Hearts
This item will modify drops from champion enemies based on your current player state. The priority list of what will drop from champion enemies in order is as follows:
Soul Hearts - When you have no red heart containers and less than 2 soul hearts
Red Hearts (Full hearts) - While at 0.5 red hearts
Keys - When you have no keys.
Bombs - When you have no Bombs
Red Hearts (Full hearts) - When you have at least half a red heart container empty
Coins - While at less than 15 cents
Keys - When you have less than 5 keys.
Bombs - When you have less than 5 bombs
Trinkets - If you have no trinkets and there are no trinkets on the ground in the room
Soul Hearts - When you have less than 6 total heart containers of any kind
If none of the above conditions are true, champions will resume dropping their regular pickups
UNLOCK: Unlock this item by defeating Greedier mode with Maggy.
Type: Passive
Item Pool: Angel Room
*, blue, triangle
Analog Stick
ItemID: 465
"360 tears!"
+0.35 Tears Up
Allows you to fire tears diagonally by holding down two of the fire buttons at once
If you are using a gamepad, this item allows you to fire in any direction
Type: Passive
Item Pool: Item Room
*, grey, gray, mushroom
Contagion
ItemID: 466
"Outbreak!"
The first enemy you kill in each new room will now explode and poison all nearby enemies, causing them to take periodic damage until they also die and explode
If you have lots of enemies near each other this can cause a chain reaction, killing lots of enemies in one go
Type: Passive
Item Pool: Item Room
*, red, glow, biological, danger
Finger!
ItemID: 467
"Watch where you point that!"
Gives Isaac a finger which floats infront of him and points in the same direction he is facing or firing. The finger deals 10% of your normal damage to all enemies in the same direction that the finger is pointing.
The finger will also deal damage to entities such as fires and poops.
Applies on-hit status effects such as the burning debuff from Fire Mind.
Spawns guppy flies if you have the Guppy transformation.
Type: Passive, Familiar
Item Pool: Item Room
*, thumb, toe, pink, bone
Shade
ItemID: 468
"It follows"
Isaac gains a shadow familiar that will follow Isaac's movement pattern delayed by 1 second and deal 2 contact damage to enemies per tick.
Shade is absorbed by Isaac after dealing 600 damage. This spawns friendly charger enemies and causes Isaac to deal 2 contact damage (same as the shade did). This effect stacks with multiple shades, scaling the contact damage each time.
UNLOCK: Unlock this item by defeating Delirium in The Void floor with Judas.
Type: Passive, Familiar
Item Pool: Devil Room, Curse Room
*, blue, white, eyes
Depression
ItemID: 469
":("
Isaac gains a cloud familiar that follows him and leaves a trail of tears on the floor which damages enemies for 2 damage per tick.
Enemies touching the cloud have a chance to activate the Crack the Sky effect, which spawns a light beam that deals damage equal to your tear damage + 20.
Type: Passive, Familiar
Item Pool: Item Room
*, pink, purple, cloud, smoke
Hushy
ItemID: 470
"Lil hush!"
Gives Isaac a small Hush familiar that bounces diagonally around the room dealing 2 contact damage per tick.
While you're firing tears Hushy will stop moving, which allows you to keep it in one place.
Hushy will block enemy tears and projectiles.
UNLOCK: Unlock this item by beating Hush with Apollyon.
Type: Passive, Familiar
Item Pool: Item Room
*, blue, pacman, ghost, face
Lil Monstro
ItemID: 471
"Ain't he cute?"
Gives Isaac a small Monstro familar, who's tears can be charged and released in a shotgun style effect, much like Monstro's main attack
Lil Mosntro's tears each deal base damage (3.5) and does not scale with damage upgrades
Type: Passive, Familiar
Item Pool: Item Room
*, head, cleft, lip, palate, hairlip, tooth
King Baby
ItemID: 472
"Lord of the dead!"
A baby familiar that follows you and causes other familiars to follow it. It stops moving while Isaac is firing tears and upon releasing the fire button, King Baby will teleport back to your location.
King Baby will always appear first in the queue of familiars.
UNLOCK: Unlock this item by beating Delirium on The Void floor with ???.
Type: Passive, Familiar
Item Pool: Shop
*, blue, crown, gold, yellow
Big Chubby
ItemID: 473
"Chub chub"
A familiar that follows Isaac and charges forwards very slowly, dealing 2.7 damage per tick to any enemies it comes into contact with.
Almost identical to the Little Chubby familiar, but this one moves much more slowly and deals less damage.
Type: Passive, Familiar
Item Pool: Item Room
*, face, yellow, brown
Tonsil
ItemID: 474
"Gross..."
Gives you a Tonsil familiar, which follows Isaac and blocks enemy projectiles.
Does not deal contact damage to enemies.
The Tonsil familiar counts as a passive item but does not appear in any item pools, meaning the only ways to find it and make it appear in your Items Collection page are a) hold the Tonsil trinket and trigger the effect, or b) start with it randomly as Eden.
Type: Passive, Familiar
Item Pool: None
*, pink, bloody, brain
Plan C
ItemID: 475
"Use with caution"
Upon use, this item deals 9,999,999 damage to all enemies in the room and then kills you 3 seconds later.
This is a single use active item, meaning it is destroyed after using it.
Does not kill both phases of multi-phase bosses like Hush or Ultra Greed.
If used to kill a boss, the kill still counts as a victory for post-it note completion marks, but the run will still get a game over.
Delirium's death animation takes longer than 3 seconds, meaning you will die before it can count as a completion mark. One exception to this is if you are playing as Lazarus or have Lazarus' Rags - you will respawn in the same room and get the kill.
Plan C is 5 times rarer than other items in the same item pool, making it less likely to appear.
UNLOCK: Unlock this item by defeating Greedier Mode with Lazarus.
Type: Active
Recharge time: One time use
Item Pool: Shop, Devil Room, Curse Room, Red Chest, Demon Beggar
*, red, pill, medicine, drug
D1
ItemID: 476
"What will it be?"
When used, the D1 duplicates 1 random pickup in the current room, including cards, runes, chests and trinkets.
If you drop your current card, rune or pill and duplicate it, this item can effectively act similar to the Blank Card and Placebo items.
Jera runes cannot be duplicated using the D1.
Duplicated chests can turn into another kind of chest randomly (e.g. Red chests).
Can be used in a shop to duplicate pickups which have not yet been purchased, and take the duplicate pickup for free.
UNLOCK: Unlock this item by defeating Greedier Mode with Isaac.
Type: Active
Recharge time: 4 rooms
Item Pool: Item Room
*, white, grey, gray, dice pip, one
Void
ItemID: 477
"Consume"
When used, Void will consume any pedestal items in the current room.
If an active item is consumed, its effect will be added to Void's effect when used, allowing you to consume multiple items and combine their effects.
If a passive item is consumed, you gain a small stat upgrade to a random stat.
Possible stat changes include: +1.0 flat damage, +0.5 tears, +0.2 speed, +0.2 shot speed, +0.5 range, +1.0 luck.
Void does not work on devil deal or shop items unless they have been bought first.
Using Void to absorb items in Boss Rush or Challenge Rooms counts as taking the items and will cause the encounter to start.
Using Void on one time use items such as Mama Mega or Diplopia will cause their effect to instantly trigger and will not give you further uses through activating Void again.
UNLOCK: Unlock this item by beating Delirium in The Void floor with Apollyon.
Type: Active
Recharge time: 6 rooms
Item Pool: Devil Room, Angel Room
*, purple, swirl, spin, black
Pause
ItemID: 478
"Stop!"
Upon use, this item freezes all enemies in the room until you press the fire button again or 30 seconds passes (whichever happens first).
Unlike other active items, bosses are not immune to this effect.
Touching a frozen enemy will still hurt you.
This item doesn not affect troll bombs - they will still explode.
Type: Active
Recharge time: 2 rooms
Item Pool: Item Room
*, green, robot, antenna
Smelter
ItemID: 479
"Trinket melter!"
Upon use, the Smelter will destroy your currently held trinket and give you the effect permanently, allowing you to stack up lots of different trinket effects.
Holding the Smelter increases the chance for a trinket to drop. (2% chance for the end of room drop to become a trinket).
If a trinket has been smelted, it won't appear a second time unless the entire trinket pool is exhausted or you restart the run (e.g. by doing a victory lap).
UNLOCK: Unlock this item by beating Mom's Heart on Hard Mode with Apollyon.
Type: Active
Recharge time: 6 rooms
Item Pool: Shop
*, grey, gray, brown, orange, steam, coffee, tea, drink, cup
Compost
ItemID: 480
"Gain more friends!"
When used, Compost doubles up the current number of blue flies and spiders you have.
When picked up, Compost will also destroy every consumable on the ground in the current room and turn each of them into a blue fly or blue spider.
If you have no pickups on the ground in the current room and no other flies or spiders, Compost will spawn 1 blue fly or blue spider.
Type: Active
Recharge time: 2 rooms
Item Pool: Shop, Secret Room
*, green, brown, grey, gray, ball
Dataminer
ItemID: 481
"109"
When used, this item will distort all the sprites and music, rotating graphics 90 degrees and translating them diagonally up/left, while leaving the hitbox in the same place. This can make it confusing while navigating the room.
Enemy hitboxes remain the same
Dataminer will randomly increase or decrease one of your stats by a small amount when used.
Gives you the Fruit Cake effect for the room when used, which will give a random tear effect with every tear fired.
All visual and tear effects reset after leaving the room.
Type: Active
Recharge time: 4 rooms
Item Pool: Item Room
* data miner, red, pickaxe, minecraft, pixel
Clicker
ItemID: 482
"Change"
When used, this item will randomly change you into another character and remove the last item you picked up.
All stat changes of the new character are applied (e.g. character damage multipliers).
This item can only reduce your heart containers and will not increase them if you change back into a character with more health. This means if you roll into The Lost, changing back to another character will leave you with only 1/2 of a soul heart.
Cannot turn you into a character that isn't unlocked yet.
Also includes Lazarus II (Lazarus' revived form) and Black Judas (effect of Judas' Shadow).
It's also possible that this item will pick the same character, making it seem like nothing happened.
Type: Active
Recharge time: 6 rooms
Item Pool: Item Room
*, grey, gray, black, remote, zapper, changer, building
MaMa Mega!
ItemID: 483
"BOOOOOOOOOM!"
A one time use item that when used will explode all objects (i.e. rocks, poop) in the room and deal 200 damage to all enemies in the current room, as well as every other room for the remainder of the floor.
Also opens the boss rush door after Mom's Foot, blue womb door after Mom's Heart, secret rooms and super secret rooms
Like all single-use items, this item cannot be absorbed and used multiple times by the Void item
Entering a room with an angel statue will destroy it and automatically spawn one of the Angel mini bosses
Type: Active
Recharge time: One time use
Item Pool: Shop, Bomb Beggar
*, bomb, face, red, lips
Wait What?
ItemID: 484
"I can't believe it's not butter bean!"
Upon use, this item will fart, pushing enemies away and causing a wave of rocks to spawn that spread outwards from Isaac in a circle, dealing 10 damage per hit to any enemies caught in it.
Can be used to open secret rooms.
Visually this item is very similar to Butter Bean.
The rock waves can destroy destructible objects, e.g. poop.
Type: Active
Recharge time: 10 seconds
Item Pool: Item Room
*, white, yellow, bean
Crooked Penny
ItemID: 485
"50/50"
When used, you have a 50% chance to double all items, consumables and chests in the current room.
If the effect fails, all pickups and items are deleted and Crooked Penny spawns 1 coin.
If there are no consumables currently on the floor, Crooked Penny spawns 1 coin.
This item works with items which can be purchased such as shop items, allowing you to spawn a free version if the effect triggers.
If used in a shop and the effect fails, a Restock box can be used to restore the shop items. This mechanic is very useful on Greed and Greedier modes.
UNLOCK: Unlock this item by defeating Delirium in The Void floor with Keeper.
Type: Active
Recharge time: 4 rooms
Item Pool: Item Room, Shop, Beggar
*, orange, brown, yellow, gold, coin, cent
Dull Razor
ItemID: 486
"I feel numb..."
Upon use this item hurts Isaac without actually taking health away, allowing you to activate any items which trigger when taking damage without losing health
UNLOCK: Unlock this item by defeating Delirium on The Void floor with Eve.
Type: Active
Recharge time: 2 rooms
Item Pool: Shop
*, blue, pink, purple
Potato Peeler
ItemID: 487
"A pound of flesh..."
When used, this item permanently removes one of your red heart containers and gives you a flat +0.2 Damage Up, the Anemic effect (+5 Range Up + red creep trail) and a Cube of Meat.
The Anemic effect will only last for the current room, but the Cube of Meat and Damage Up are both permanent.
Only works for red hearts and has no effect when used if you only have soul/black hearts.
Has no recharge time and can be used as often as you like.
It is possible to generate multiple meatboys by stacking more than 4 Cubes of Meat.
Type: Active
Recharge time: None
Item Pool: Shop, Demon Beggar
*, brown, metal, silver, grey, gray
Metronome
ItemID: 488
"Waggles a finger"
When used, this item gives you the effect of a random item for the rest of the room
Using this item multiple times in the same room will replace the previous item's effect with a new one
Certain items can be activated with this item which have unexpected effects and many items will do nothing
Items do not grant consumable drops which would normally occur when that item is picked up
Most flight-granting items have cosmetic effects only, and will not allow you to fly
Items that usually give HP up will not give extra health when gained from Metronome
UNLOCK: Unlock this item by defeating Greedier Mode with Eden.
Type: Active
Recharge time: 2 rooms
Item Pool: Item Room
*, grey, gray, brown
D infinity
ItemID: 489
"Reroll forever"
When picked up, this item gives you a random Dice active item, which will transform into another random dice upon use
Possible dice include: D4, D6, D8, D10, D12, D20, D100
All dice given by this item have a 2 room recharge time
UNLOCK: Unlock this item by defeating Delirium in The Void floor with Isaac.
Type: Active
Recharge time: 2 rooms
Item Pool: Item Room
*, grey, gray, cube, box, oo, square
Eden's Soul
ItemID: 490
"..."
A one time use active item that when used, will spawn 2 random item pedestals from the item pool associated with the current room (e.g. in an Angel room, this will spawn 2 Angel room items)
Starts with 0 charge and requires 12 charges to use
UNLOCK: Unlock this item by defeating Delirium in The Void floor with Eden.
Type: Active
Recharge time: 12 rooms (one time use)
Item Pool: Angel Room
*, blue, circle, spikes
Acid Baby
ItemID: 491
"Pills pills pills!"
Every 3 rooms Acid Baby will drop a random pill
The first pill drops after 2 rooms
Every time you use a pill, Acid Baby will poison all enemies in the room, dealing double your tear damage to each of them
Type: Passive, Familiar
Item Pool: Item Room, Demon Beggar
*, brown, yellow, face, red, eyes, ghost
YO LISTEN!
ItemID: 492
"Yo listen!"
+1 Luck Up
A familiar fairy that will float around the room and highlight the location of any secret room doors, tinted rocks or trapdoors under rocks
Upon entering a new room, if there is an undiscovered secret room or tinted rock, it will move directly to the point of interest, otherwise it will just randomly fly around the room
Type: Passive, Familiar
Item Pool: Item Room
* navi, blue, green, fly
Adrenaline
ItemID: 493
"Panic - power"
For every empty red heart container, Isaac gains +0.2 Damage Up and his body increases in size
Only works on full hearts - damage does not change if Isaac is missing 1/2 of a heart in one container.
Healing empty red heart containers will remove the damage increases
Has no effect for The Lost and ???, as they cannot gain red heart containers (except for counting towards the Spun transformation)
Counts as 1 of 3 syringe items needed towards the Spun transformation.
Type: Passive
Item Pool: Item Room
* Adderline, pink, syringe, needle, injection
Jacob's Ladder
ItemID: 494
"Electric tears"
Isaac gains electric tears, which fire 1-2 sparks of electricty in random directions upon hitting any object or enemy
The electricty deals half of your normal tear damage
Tear effects will still apply to your electricty sparks in a lot of cases (e.g. Spoon Bender will give them a homing effect)
Tears which fall naturally to the floor at max range do not generate sparks
Type: Passive
Item Pool: Item Room
*, silver, metal, grey, gray, blue
Ghost Pepper
ItemID: 495
"Flame tears"
Each tear now has a small chance to be a fire instead, which deals 23 damage to enemies that come in contact with it.
The fire will remain in place and shrink in size when deals damage to something. After dealing enough damage it will eventually disappear
Type: Passive
Item Pool: Item Room
*, white, face
Euthanasia
ItemID: 496
"Needle shot"
Each tear now has a small chance (3.33%) to be a needle instead, which deals 3 times your tear damage.
If a needle hits a non-boss enemy it will instantly kill it and will explode into a circle of 10 more needles
The 10 spawned needles will also deal 3 times your tear damage, but won't instantly kill enemies or explode into more needles
The chance to for each tear to become a needle is affected by your luck stat and at +15 Luck it will activate every time
Counts as 1 of 3 syringe items needed towards the Spun transformation.
UNLOCK: Unlock this item by defeating Delirium in The Void floor with Lilith.
Type: Passive
Item Pool: Item Room, Curse Room, Demon Beggar
*, black, syringe, injection, euthansia, dang, dan gheesling, dangheesling, dangDEB8, you piece
Camo Undies
ItemID: 497
"Camo kid"
Upon entering a new room, Isaac will become camouflaged and enemies won't attack until you start firing tears
Bosses are immune to this effect
Type: Passive
Item Pool: Item Room
*, pink, purple, goggles
Duality
ItemID: 498
"You feel very balanced"
Any time a devil or angel room door opens after a boss, the other one will also spawn
The extra door will only spawn if a devil or angel room was randomly chosen to spawn already
After entering one of the doors, the other will disappear
If there isn't an available wall for the extra door to spawn on, only one door will spawn (i.e. in a small boss room)
UNLOCK: Unlock this item by defeating Greedier Mode with Lilith.
Type: Passive
Item Pool: Devil Room, Angel Room
*, black, white, circle
Eucharist
ItemID: 499
"Peace be with you"
Gives you a 100% chance to find an Angel Room on every valid floor after defeating the boss
Doesn't spawn an angel room on any floor where it is normally not possible to find one (e.g. Basem*nt 1, Cathedral, Sheol etc.)
Keeps the chance at 100% even after entering and leaving the angel room, meaning the door will not close after visiting
Makes it impossible to find Devil Rooms again, unless you find a way to remove or reroll this item away, or find the Duality item
UNLOCK: Unlock this item by defeating Delirium in The Void floor with Maggy.
Type: Passive
Item Pool: Angel Room
*, golden, yellow, white, cross
Sack of Sacks
ItemID: 500
"Gives Sacks!"
A sack familiar that drops a sack every 5 or 6 rooms cleared (alternates between 5 and 6)
UNLOCK: Unlock this item by defeating Greedier Mode as Cain.
Type: Passive, Familiar
Item Pool: Shop, Golden Chest
* back in black, ac/dc, bag, brown, pouch, pocket, bulge
Greed's Gullet
ItemID: 501
"Money = Health!"
Gives you an extra heart container for every 25 coins you are currently holding, up to a maximum of 4 extra HP at 99 coins held
If your coin counter goes below the required amount for a heart container, you will lose it again
This item works for the Keeper, allowing him to exceed his usual 2 health containers.
However, if Keeper drops to under 2 health coins as a result of Greed's Gullet, he is unable to use a HP Up to increase his health back to 2, and has to regain the lost coins to do so.
UNLOCK: Unlock this item by beating Challenge #35 (Pong).
Type: Passive
Item Pool: Secret Room
*, dollar, cash, sack, bag, pouch
Large Zit
ItemID: 502
"Creep shots"
Gives you a random chance while firing tears to also fire a creep shot, which deals double your tear damage and places white creep on the floor infront of you that slows enemies down if they walk through it
Unlike some similar tear effects, your luck stat does not alter the chance for this effect to activate
A creep shot is also fired in a random direction after taking damage
Type: Passive
Item Pool: Item Room
*, pink, yellow, toe, nail, tooth
Little Horn
ItemID: 503
"Science!"
While firing tears you have a 5% chance to fire a piercing void tear, that will instantly kill any non-boss enemy it comes into contact with
The chance to for each tear to become a void tear is affected by your luck stat and at +15 Luck it will activate 20% of the time
Isaac also grows a horn on his head, which causes you to deal contact damage to enemies by running into them (this effect deals base damage of 3.5 per tick)
Type: Passive
Item Pool: Curse Room, Demon Beggar
*, black, tooth
Brown Nugget
ItemID: 504
"Friendly Fly"
When used, will spawn a fly turret that doesn't move and fires tears at nearby enemies
Only persists for the current room
The fly's bullets deal 2 damage each and do not scale with your own damage stat
UNLOCK: Unlock this item by defeating Ultra Greed as Apollyon.
Type: Active
Recharge time: 7 seconds
Item Pool: Item Room
*, brown, cube, rock, brownie, dirt
Poke Go
ItemID: 505
"Gotta catch em..."
At the start of each new hostile room, you have a 20% chance to gain a random charmed familiar which will fight for you
The charmed enemy has its own health bar and will die if it takes enough damage
Charmed enemies persist between each room and floor for as long as they stay alive
Allows you to have more than one charmed familiar at a time if you can keep them alive
Type: Passive
Item Pool: Shop
* pokemon, phone, black, green, blue, gps
BackStabber
ItemID: 506
"Watch your back!"
Every time one of your tears hits an enemy, it has a chance to start bleeding, which will cause it to take damage equal to 10% of its maximum health every 5 seconds.
Damaging enemies from behind gives the bleed effect a 100% chance to apply
The tear that inflicts the bleed effect also deals double damage
The bleed effect cannot be applied to immune enemies (e.g. bosses and mini bosses)
Type: Passive
Item Pool: Item Room
*, knife, dagger, red, heart, silver, knife
Sharp Straw
ItemID: 507
"More blood!"
When used, Sharp Straw will deal damage to all enemies in the room
The damage dealt is equal to Isaac's current tear damage plus 10% of the enemy's max health
Every time this item deals damage, it has a 15% chance to drop 1/2 red hearts or 1/2 soul hearts.
Half red hearts will always drop when the player has at least one red heart container, otherwise half soul hearts will drop.
Type: Active
Recharge time: 8 seconds
Item Pool: Item Room
*, blue, white, stripe
Mom's Razor
ItemID: 508
"It's sharp!"
A razor blade orbital that deals contact damage and applies the bleeding status effect to enemies, which will cause them to take damage equal to 10% of their total health every 5 seconds
The contact damage dealt by Mom's Razor is equal to 20% of your current tear damage (scales with damage upgrades)
Does not block enemy shots
The bleed effect does not affect bosses
Its speed is not affected by the Guardian Angel item
Counts as 1 of 3 mom items needed towards the Mom transformation.
Type: Passive, Familiar
Item Pool: Item Room, Curse Room
*, pink, t
Bloodshot Eye
ItemID: 509
"Bloody friend"
An eye orbital that shoots a tear every 2 seconds that deals 3.5 damage and deals 2 contact damage per tick to enemies
Tears will fire in the direction it is currently facing and do not target enemies
Unlike other orbitals, this item does not block enemy projectiles
The damage dealt by this orbital does not scale with damage upgrades
Its speed is not affected by the Guardian Angel item
Type: Passive, Familiar
Item Pool: Item Room
*, pink, red
Delirious
ItemID: 510
"Unleash the power!"
When used, spawns a charmed random white delirium version of a boss, that will fight for you and kill other enemies for the rest of the current room
Possible bosses spawned include most bosses in the game
Some bosses' effects can harm Isaac. For example if the spawned boss leaves creep, it can damage Isaac
UNLOCK: Unlock this item by defeating Delirium for the first time on any character
Type: Active
Recharge time: 12 rooms
Item Pool: Angel Room
*, yellow, eyes, face, round
Angry Fly
ItemID: 511
"He's violent"
A familiar fly that orbits around a random enemy in the room until that enemy dies, dealing 2 contact damage to other enemies
Angry Fly will move to the next enemy after the one it is currently orbiting dies, until the room is cleared, at which point it will return to orbiting Isaac
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Custom Phase
UNLOCK: Unlock this item by transforming into Beelzebub (Achieved by picking up 3 fly related items, see Transformations page for full list).
Type: Passive, Familiar
Item Pool: Item Room
*, red, cube, wings, face
Black Hole
ItemID: 512
"Nothing can escape"
A throwable active item that places a black hole on the ground where it lands, sucking all enemies into it for 6 seconds
Enemies stuck inside the black hole take rapid damage over time
The Black Hole will also suck Isaac into it, but with a much weaker effect than to enemies
The Black Hole will destroy nearby obstacles such as rocks and pots
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Custom Phase
Type: Active
Recharge time: 4 rooms
Item Pool: Item Room
*, pink, purple, black, planet
Bozo
ItemID: 513
"Party time!"
+0.1 Damage Up
+1 Soul Heart
Adds a random chance for an enemy in the current room to become charmed or feared briefly
Adds a random chance to spawn a rainbow poop upon taking damage
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Electoon
UNLOCK: Unlock this item by breaking 5 rainbow poops.
Type: Passive
Item Pool: Item Room
*, red, white, stripe, hat, clown, waldo, wally
Broken Modem
ItemID: 514
"LAG!"
Causes random enemies to 'lag' at random intervals, causing them to freeze in place for a second
The lag effect can also apply to tears, projectiles and consumables on the ground
While held, this trinket has a 25% chance to double up any end of room drops (similar to the Contract from Below effect)
Isaac's Luck stat affects how often the lag effect occurs
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Freezenification
UNLOCK: Complete 7 Daily Challenges (30 on console)
Type: Passive
Item Pool: Shop
*, black, cube, red, vcr, vhs
Mystery Gift
ItemID: 515
"Wrapped up nice for you!"
A one-time use item that spawns a random item from the current room's item pool, with a chance for it to spawn Lump of Coal or The Poop instead
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Mills
Type: Active
Recharge time: One time use
Item Pool: Shop
*, green, red, present, bow, xmas, christmas
Sprinkler
ItemID: 516
"Sprinkles."
When used, spawns a Sprinkler that rotates in a circle, spraying tears in all directions.
Will also synergize with some other items, such as Mom's Eye, Brimstone, Dr. Fetus, Tech X or Loki's Horns
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Kieran and Stewartisme
Type: Active
Recharge time: 4 rooms
Item Pool: Item Room
*, grey, gray, silver, metal, eye, stick
Fast Bombs
ItemID: 517
"Faster Bomb Drops!"
+7 Bombs
Allows you to rapidly place bombs on the ground
Added as part of the Afterbirth+ Booster Pack #1
UNLOCK: Unlock this item by defeating Lil Horn 20 times.
Type: Passive
Item Pool: Item Room
*, lightning, bolt, yellow, black
Buddy in a Box
ItemID: 518
"What could it be?!"
When picked up, gives Isaac a random familiar which has a random sprite and tear effect
The familiar will be fully randomized again upon entering the next floor
The appearance is chosen from a random co-op baby sprite
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Ashkait and Scayze
Type: Passive, Familiar
Item Pool: Shop
*, brown, orange, snake, mgs, cardboard
Lil Delirium
ItemID: 519
"He's Delirious"
A familiar that will transform into another random familiar every 10 seconds, copying their behaviour and effect
Can be any other familiar, including (but not limited to) Lil Brimstone, Bob's Brain, BBF, Meatboy, Rotten Baby
Familiars appear as a white Delirium version of the original
Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Ashkait and Scayze
Type: Passive, Familiar
Item Pool: Angel Room, Devil Room
*, white, yellow, eyes, face, circle
Jumper Cables
ItemID: 520
"Bloody recharge!"
This item gives you 1 bar of charge on your active item for every 15 enemies you kill
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by Ashkait and Scayze
UNLOCK: Unlock this item by picking up any 3 of these items in a single run: 9 Volt, The Battery, Car Battery, AAA Battery, Watch Battery.
Type: Passive
Item Pool: Greed Mode Item Room, Shop
*, red, black, metal, crocodile, clips
Coupon
ItemID: 521
"Allow 6 weeks for delivery"
When used, the coupon causes one random item in the shop to become free
While held, guarantees a random item or pickup from the shop to be half price
The effect of this item also works in Devil Rooms, allowing you to take one random item for free
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by Plumbo
Type: Active
Recharge time: 6 rooms
Item Pool: Item room, Shop, Beggar
*, paper, square, green, pink, white, barcode, letter, postcard
Telekinesis
ItemID: 522
"The power of mind!"
An active that causes all enemy tears to be held in place and then thrown back away from Isaac for a period of 3 seconds
Has a recharge time of about 2 seconds
Added as part of the Afterbirth+ Booster Pack #2
Type: Active
Recharge time: 2 seconds
Item Pool: Item Room, Greed Mode Item Room
*, blue, glow, hand
Moving Box
ItemID: 523
"Pack and unpack"
When used, the box will pick up a maximum of 6 items. Using the box again will put the picked up items back on the floor again, allowing you to move things between rooms
Can move any of the following: Batteries, Items, Trinkets, Hearts, Keys, Bombs, Coins, Chests and more
Using Moving Box with Car Battery will trigger 2 interactions at the same time: First it will drop all items currently inside the box and secondly will then pick up the current room's contents.
When used in a room with 2 items you can choose from (e.g. There's Options, Double item room, Boss Rush) the Moving Box will pick only one of the items at random
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by HurleyFarrill
UNLOCK: Unlock this item by using Pandora's Box in the Dark Room floor.
Type: Active
Recharge time: 4 rooms
Item Pool: Shop
*, brown, orange, cardboard
Technology Zero
ItemID: 524
"Static tears!"
Your tears will now be connected together by beams of electricity which deals damage to enemies they hit
Added as part of the Afterbirth+ Booster Pack #2 and based on the Steam Workshop mod created by Ashkait and Scayze
UNLOCK: Unlock this item by having 2 technology items at once.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*, black, white, grey, gray, round, circle, eye, key, hole, coin, slot, laser
Leprosy
ItemID: 525
"You're tearing me apart!"
Taking damage will spawn an orbital that rotates around Isaac, dealing contact damage to enemies and blocking enemy projectiles
A maximum of 3 Leprocy orbitals can be active at one time
Using the orbital to deal damage to enemies can cause it to break
Added as part of the Afterbirth+ Booster Pack #2. Based loosely on the Steam Workshop mod created by Extreme Ninja Home Makeover with changes by Edmund McMillen
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*, lepracy, leprasy, leprosy, pink, red, bloody, lump
7 Seals
ItemID: 526
"Lil Harbingers!"
Gives you a random Harbinger familiar that changes every 10 seconds.
Each harbinger behaves differently, based on any of the original 5 horsem*n bosses
Added as part of the Afterbirth+ Booster Pack #3. Based on the Steam Workshop mod created by by Scayze and Ashkait
Type: Passive
Item Pool: Devil Room, Angel Room
*, bloody, paper, script, white, red, toilet paper
Mr. ME!
ItemID: 527
"Caaan Do!"
Upon use, this item summons a ghost near Isaac that will follow him around. Also summons a blue crosshair which can be moved around freely. After a few seconds, the crosshair will disappear, and the Ghost will do certain things based on what you targeted:
Items, pickups, trinkets: Brings them to Isaac. Works in shops and devil deals as well, allowing you to take them for no cost. Stealing an item has a chance to fail (a buzzer sound will play if it fails)
Buttons: Presses the button
Enemies: Attacks the enemy until either the ghost or the enemy dies
Doors: Opens the door, even if it is locked
Secret room entrances: Explodes and opens the entrance
Boss rush door: Will open the Boss Rush door from either side, allowing you get into and escape the Boss Rush.
Slot machines, dead shopkeepers: Charges towards them and explodes them
Added as part of the Afterbirth+ Booster Pack #3. Based on the Steam Workshop mod created by Jean-Alphonse
UNLOCK: Unlock this item by opening 20 locked chests.
Type: Active
Recharge time: 4 rooms
Item Pool: Shop
*, mr me!, Mr Meeseeks, rick and morty, brown, chest, szechuan sauce
Angelic Prism
ItemID: 528
"Eclipsed by the moon"
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. Based on the Steam Workshop mod created by electoon and Erfly
Type: Passive, Orbital
Item Pool: Angel Room
*, dark side of the moon, rainbow, red, yellow, green, white, triangle, pink floyd, thought
Pop!
ItemID: 529
"Eyeball tears!"
Replaces Isaac's tears with eyeballs that can bounce off of each other
Issac's tears are no longer limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle
Added as part of the Afterbirth+ Booster Pack #3. Based on the Steam Workshop mod created by Scayze and Ashkait
Type: Passive
Item Pool: Item Room
*, eyes, eyeball, bloody, white, red, googly googley, bank shot
Death's List
ItemID: 530
"Just hope you're not next"
Upon entering a room, a skull appears over a random enemy's head.
Killing the marked enemy will cause the skull to move to a different enemy.
If all enemies in the room are cleared in the order they are marked, Isaac gains a random reward from one of the following: Soul heart, Key, Pill, Bomb, Nickel, +0.2 Speed, +0.5 Range, +0.5 Tears, +1 Flat damage or +1 luck
Killing enemies in the wrong order will end the streak and deny you any extra rewards.
Added as part of the Afterbirth+ Booster Pack #4. Based on the Steam Workshop mod created by Merlo.
Type: Passive
Item Pool: Devil Room
*, parchment, quill, script, pact, feather, scroll
Haemolacria
ItemID: 531
"I'm seeing red..."
With Haemolacria, Isaac's tears become bloody and now fire by in the air in an arc.
Upon hitting the floor, an obstacle or enemy, the bloody tear will burst and fire lots of smaller tears at random directions around the impact point
Tears Down - (Tear delay * 2) + 10
Your damage stat is unaffected by this item, however the large bloody tear does +31% of your tear damage and the smaller scattering tears deal 50-80% of your tear damage.
Added as part of the Afterbirth+ Booster Pack #4. Based on the Steam Workshop mod (originally called Water Balloon) created by HiHowAreYou.
UNLOCK: Unlock this item by picking up the Blood Clot item 10 times.
Type: Passive
Item Pool: Item Room
*, water balloon, blood, heamolacria
Lachryphagy
ItemID: 532
"Feed them!"
Isaac's tears slow down over time while moving across the room, and upon stopping completely or hitting an object will burst into 8 smaller tears which fire in all directions.
This item will also allow you to 'feed' a tear with other tears. Doing so will cause it to increase in size, and also increase their damage and the damage of the burst tears.
Once a tear is fed 5 times, it will immediately burst
Tears in the burst will deal half the damage the main tear would have.
Tears which hit an enemy do not burst
Added as part of the Afterbirth+ Booster Pack #4. Based on the Steam Workshop mod (originally called Hungry Tears) created by Echo
Type: Passive
Item Pool: Item Room
*,
Trisagion
ItemID: 533
"Smite thy enemy"
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. Based on the Steam Workshop mod (originally called Lightshot) created by Wyvern and TRPG
Type: Passive
Item Pool: Angel Room
*,
Schoolbag
ItemID: 534
"Extra active item room"
Gives you an extra active item slot
Pressing the CTRL key allows you to switch active items
Functions exactly the same as the Antibirth item with the same name
Added as part of the Afterbirth+ Booster Pack #4.
UNLOCK: Unlock this item by entering every Shop from the first floor up to Mom's Foot (Depths 2).
Type: Passive
Item Pool: Shop
*,
Blanket
ItemID: 535
"You feel safe"
+1 Soul Heart
Heals 1 red heart when picked up
Grants you a shield when entering the Boss Room, which prevents damage from 1 hit, then disappears
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Ratlah
UNLOCK: Unlock this item by sleeping in 10 different beds.
Type: Passive
Item Pool: Shop
*,
Sacrificial Altar
ItemID: 536
"He demands a sacrifice"
When used, this item will sacrifice up to 2 of your familiars (chosen at random), and spawn a random Devil Room item for each familar sacrificed this way
In addition to the familiars, any blue flies or spiders will be converted to 1 coin each.
If Guardian Angel, Sworn Protector, or Seraphim is sacrificed, Satan will be extra happy and reward you with 2 black hearts.
Incubus won't be sacrificed if you're playing as Lilith
If used while you have no familiar, this item will do nothing and won't consume the item
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Niro
Type: Active
Recharge time: Single use
Item Pool: Curse Room
*, sacraficial, sacrafice
Lil Spewer
ItemID: 537
"Puking buddy"
A familiar with a charged attack, that spawns a line of creep on the floor which damages enemies that walk over it
Spawns 1 random pill when picked up
The familiar and its creep will change randomly when Isaac uses a pill.
Possible creep types include green (deals damage), black (slows enemies), red (deals damage, forms a line with a larger puddle), yellow (deals damage, forms a short-range cone) and white (slows enemies, forms a ring)
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Strawrat and Aczom
UNLOCK: Unlock this item by dying to your own Ipecac explosion.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*,
Marbles
ItemID: 538
"Choking hazard"
Spawns 3 random trinkets when picked up
Upon taking damage, you have a random chance to consume one of your currently held trinkets, gaining its effect permanently
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Amethyst
UNLOCK: Unlock this item by using 5 Gulp! pills in one run.
Type: Passive
Item Pool: Boss Room
*,
Mystery Egg
ItemID: 539
"Sacrificial insemination"
A familiar which follows Isaac and, upon taking damage, will spawn a charmed enemy that will fight for you
When the charmed enemy is spawned the egg will crack, but regenerate in the next room
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Strawrat and Aczom
UNLOCK: Unlock this item by spawning 3 charmed enemies in a single room.
Type: Passive
Item Pool: Item Room
*,
Flat Stone
ItemID: 540
"Skipping tears"
Flat Stone causes your tears to bounce across the room
Whenever a tear bounces, it deals splash damage to nearby enemies for 25% of your tear damage
Added as part of the Afterbirth+ Booster Pack #5. Based on the Steam Workshop mod created by Maddogs
UNLOCK: Unlock this item by picking up Rubber Cement 5 times.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*,
Marrow
ItemID: 541
"HP up?"
+1 Bone Heart
Spawns 3 red hearts on the ground when picked up
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating Mom's Heart on hard mode as The Forgotten.
Type: Passive
Item Pool: Boss Room
*,
Slipped Rib
ItemID: 542
"Projectile shield"
This item gives you an orbital, which will reflect projectiles back at enemies
Unlike some other orbitals, Slipped Rib doesn't deal contact damage to enemies
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating the Isaac boss as The Forgotten.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*,
Hallowed Ground
ItemID: 543
"Portable sanctuary"
A familiar which follows Isaac and spawns a white poop when you take damage
The white poop gives an aura that cuts your tear delay in half (Tears up) and has a chance to block damage
The aura disappears if the poop is destroyed
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating Hush as The Forgotten.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*,
Pointy Rib
ItemID: 544
"Stabbing time"
A familiar that can be aimed with the fire buttons similar to the Finger item, dealing contact damage to enemies equal to your tear damage
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating Satan as The Forgotten.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*,
Book of the Dead
ItemID: 545
"Rise from the grave"
When used, this item will spawn a bone orbital or charmed Bony for each enemy killed in the current room.
The orbitals and charmed enemies persist when travelling between rooms.
Bone orbitals break after dealing enough damage or blocking too many shots.
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating Delirium in The Void floor as The Forgotten.
Type: Active
Recharge time: 4 rooms
Item Pool: Item Room, Library, Devil Room
*,
Dad's Ring
ItemID: 546
"Father's blessing"
A passive item that puts a yellow ring around Isaac. Enemies are frozen in place while touching the yellow ring
Enemies touching the ring will stay permanently frozen until you move away, except for bosses which only get a temporary freeze effect after touching it
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating Ultra Greedier as The Forgotten.
Type: Passive
Item Pool: Secret Room
*,
Divorce Papers
ItemID: 547
"Tears up + you feel empty"
+1 Bone Heart
+0.7 Tears Up
When you pick this item up, the Mysterious Paper trinket is spawned on the ground
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating Boss Rush as The Forgotten.
Type: Passive
Item Pool: Boss Room
*,
Jaw Bone
ItemID: 548
"Fetch"
A familiar that flies across the room every few seconds while firing and damages enemies (2x your tear damage)
Can also be used like the Boomerang to pick up consumables on the ground
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating ??? in The Chest floor as The Forgotten.
Type: Passive
Item Pool: Item Room, Greed Mode item Room
*,
Brittle Bones
ItemID: 549
"Everything hurts"
When picked up, this item replaces all of your red heart containers with 6 Bone Hearts
Every time you lose a bone heart, lots of bones fire in all directions damaging any enemies hit and you gain a permanent +0.5 Tears Up
For the Lost and Keeper characters, this item simply gives a permanent Tears Up.
Added as part of the Afterbirth+ Booster Pack #5.
UNLOCK: Unlock this item by defeating The Lamb in the Dark Room floor as The Forgotten.
Type: Passive
Item Pool: Item Room, Greed Mode Item Room
*,
Broken Shovel
ItemID: 550
"It feels cursed"
Obtained by beating the Basem*nt 1 boss within 1 minute, then bombing the large shadow that appears in the middle of the starting room
While held, Mom's Foot will stomp on you from above twice every few seconds, and she will continue to stomp for as long as you hold this item.
Using the Broken Shovel will stop Mom stomping you for the rest of the current room (or current wave if you're in the boss rush or challenge room).
Beating the Boss Rush while holding this item will drop the second half of the Broken Shovel, which combine to create Mom's Shovel, which is used to unlock The Forgotten character
Dropping the Broken Shovel will cause it to disappear if you leave the room
NOTE: This item will not drop unless you have beaten The Lamb at least once
Added as part of the Afterbirth+ Booster Pack #5 and used in the quest to unlock The Forgotten character
Type: Active
Recharge time: 4 rooms
*,
Broken Shovel
ItemID: 551
"Lost but not forgotten"
Drops after beating the Boss Rush while holding the other half of the Broken Shovel (see previous item for more details)
Combines with the first Broken Shovel piece to create Mom's Shovel (see next item for more details)
Added as part of the Afterbirth+ Booster Pack #5 and used in the quest to unlock The Forgotten character
Type: Passive
*,
Mom's Shovel
ItemID: 552
"Lost but not forgotten"
When used, spawns a trapdoor that leads to the next floor (has a 10% chance to be a crawl space instead)
Unlocks The Forgotten character when used on a mound of dirt that appears in a room in The Dark Room floor
Obtained by combining the two Broken Shovel pieces. The first piece drops by beating the first floor boss within 1 minute then bombing the shadow in the first room. The second piece drops after beating the Boss Rush as long as you are holding the first Broken Shovel piece (see previous 2 items for full details).
After The Forgotten is unlocked, using it on the mound of dirt again just spawns a random type of chest
Added as part of the Afterbirth+ Booster Pack #5 and used in the quest to unlock The Forgotten character
Type: Active
Recharge time: 4 rooms
*,
