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Anarchist Cookbook Spawns six troll bombs.

The Bean Releases a cloud of poison.

Best Friend Deploys a decoy Isaac that eventually explodes with an increased blast radius.

The Bible Upon activation, Isaac gains Flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan, Isaac, or ??? unless he has The Wafer.

Blank Card Has the same effect as the card or rune currently held by Isaac.

Blood Rights Damages all enemies in the room, but deals a half-heart of damage to Isaac with each use.

Bob's Rotten Head Upon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.

The Book Of Belial Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it. Upon use increases damage by 2 for the current room and by a further +50% if the character also has the

Blood Of The Martyr.

Book Of Revelations Adds 1 Soul Heart and makes the next boss a Horseman (except on XL floors and floors with fixed bosses such as Mom).

Book Of Secrets Upon being activated for the first time on a given floor, grants the effect of the Treasure Map. Upon being activated for the second time, grants the effects of The Compass. Upon the third activation, grants the effects of the Blue Map. All effects wear off upon moving to the next floor.

Book Of Shadows Upon use, creates a protective shield nullifying all types of damage for a short duration.

The Book Of Sin Spawns a random Pick Up, Pill, Card, or Trinket. 4

The Boomerang Throws a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups. 4 seconds

Box Of Spiders Summons 2-4 Blue Spiders. 2

Breath Of Life Grants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage. 6 seconds

Butter Bean Isaac farts and pushes back nearby enemies. 3 seconds

The Candle Throws out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.

Converter When used, converts two soul hearts into a heart container.

Crack The Sky Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.

Crystal Ball Reveals the map (except the Super Secret Room) and drops a random Tarot Card or Soul Heart.

D4 Rerolls all upgrades on the player. (Does not reroll Azazel's brimstone).

The D6 Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.

D10 Rerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).

D20 Rerolls all pickups in the current room.

D100 Upon use, rerolls all passive items on Isaac like the D4, every pedestal item on the room like the D6 and every pickup like the D20.

Dad's Key Opens all doors in the current room when activated, including doors which require a Key to open and entrances to secret rooms. Opens the big doors in the first room of both The Chest and The Dark Room.

Dead Sea Scrolls Triggers the effect of a random activated item from a list of possible options (not every activated item is included).

Deck Of Cards Gives Isaac a random Tarot Card.

Doctor's Remote Sets a big red target on the ground (similar to the Epic Fetus item) which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all

enemies caught in its blast radius.

Flush! Changes all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune).

Forget Me Now When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.

The Gamekid Upon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability and increased speed, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.

Guppy's Head Spawns 2-4 Blue Flies to damage enemies.

Guppy's Paw Removes one Heart Container in exchange for gaining 3 Soul Hearts. none

Head Of Krampus Fires a cross-patterned brimstone shot, just like the Fallen and Krampus shoot.

How To Jump Gives Isaac the ability to jump (over gaps, spikes, etc.).

The Hourglass Upon activation, enemies and their projectiles are slowed down for a short duration.

Isaac's Tears Shoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.

IV Bag Upon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the Blood Donation Machine. none

The Jar When at full health, up to 4 extra hearts can be stored in the jar. none

Kamikaze! Creates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius. none

Lemon Mishap Creates a small yellow pool of Creep, which damages enemies that cross it. 2

Magic Fingers For 1 Coin, damages all enemies in the room. none

Mom's Bottle Of Pills Gives Isaac a random Pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.

Mom's Bra Upon use petrifies all enemies in the current room for approximately 4 seconds.

Mom's Pad Upon use inflicts fear to all enemies in the room for 5 seconds.

Monster Manual Summons a random familiar for the current room. Can summon familiars not yet unlocked.

Monstro's Tooth Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.

Mr. Boom Drops a bomb.

My Little Unicorn Upon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and instead dealing contact damage to enemies.

The Nail Adds one Soul Heart and allows the breaking of Rocks and damaging enemies by simply walking over them. Increases Damage and decreases Speed. All effects except for the Soul Heart wear off upon leaving the room.

The Necronomicon Damages all enemies in the room significantly.

Notched Axe Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.

Pandora's Box Upon use, spawns certain Pickups or Items depending on the floor it is used on. Single-use.

The Pinking Shears Separates Isaac's head and body for the current room. Isaac's head, which now has flight, will be under the player's control, while his body will seek out enemies to attack by contact damage.

The Pony Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies.

The Poop Spawns a pile of poop where the character is standing and knocks nearby monsters back.

May yield pickups like regular poop.

Portable Slot Upon activation, 1 coin will be consumed, and a random Pick Up may drop, similar to the Slot Machine.

Prayer Card Grants an Eternal Heart per use.

Razor Blade Upon use deals one heart damage and grants +1.2 damage for the current room.

Red Candle Throws a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots. 4 seconds

Remote Detonator Bombs you place explode only when you use this item. Gives 5 bombs.

Satanic Bible Upon activation, Isaac gains a black heart.

Scissors Upon use, turns Isaac's head into a stationary familiar which fire the same tears as the headless body for the current room.

Shoop Da Whoop! Fires a laser from Isaac's mouth.

Spider Butt Damages all enemies in the room and slows them and their projectiles down.

Tammy's Head Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as Poison) of Isaac's tears.

Telepathy For Dummies Upon activation, grants homing tears for the current room.

Teleport Teleports you to a random room on the level.

Undefined Teleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.

Unicorn Stump Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.

We Need To Go Deeper! A trapdoor to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.

White Pony Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies while also casting the effect of Crack The Sky.

Yum Heart Restores 1 whole Red heart.

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