Quality Blood Clot: All tears are larger, with increased damage (as opposed to every 2nd tear like Blood Clot alone). Enemies that are killed by the ice tears will become frozen, Frozen enemies never unfreeze and are considered dead by the game. 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. Unlocked from Challenge #25 - Have a Heart, Feels like I'm walking on sunshine! Can fire tears but is immune to damage, Tainted Eden - Items taken before Birthright no longer get rerolled when taking damage, Tainted Lost - Grants an extra life. Transformations Quality Cain has a 50% chance of firing a shot with the effects of Blood Clot . Poops spawned by Tainted ??? Chapters The door can only be opened if you have The Polaroid, The Negative or Faded Polaroid (the item/trinket is taken away when it opens). Unlocked from Challenge #24 - PAY TO PLAY, Power Pill - Gives you invulnerability and the ability to damage enemies for a short while (similar to The Gamekid effect), Re-Lax - Causes Isaac to spawn poops behind him while he walks for a few seconds. UNLOCK: Unlock this card by opening Mom's Box on the Home floor. It can spawn familiars you haven't unlocked yet! Bosses Fire Dips burn enemies and leave a fire behind on death. No wind could lift those waves, grey metal, poisonous foggy waters. Brimstone is a passive item. 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. ?, Satan and The Lamb as Tainted Azazel, When entering a new room, gives a small chance to gain Azazel's short-range Brimstone laser for the current room and the ability to fly, UNLOCK: Unlock this trinket by defeating Mother as Tainted Azazel, Spawns 2 friendly Dips upon clearing a room, Dips that spawn after killing a Squirt turn friendly, UNLOCK: Unlock this trinket by defeating Isaac, ?? . - Every HP upgrade is now worth 2 soul hearts. in The Chest as Apollyon, Upon entering a room with enemies, spawns a Black Locust that deals quadruple Isaac's damage, applied as two hits of double damage, UNLOCK: Unlock this trinket by defeating The Lamb as Apollyon, At the start of each new hostile room you spawn 2-5 white attack flies, which will target a nearby enemy and deal double your tear damage to it, UNLOCK: Unlock this trinket by defeating Boss Rush as Apollyon, When killing an enemy, you have a very small chance to gain the ability to fly for the rest of the room, UNLOCK: Unlock this trinket by defeating Greedier Mode with Azazel, Stem Cell heals Isaac's red heart containers to 50% each floor, If Isaac already has 50% health or more, it heals half of a heart instead, UNLOCK: Unlock this trinket by defeating Greedier Mode with Samson, Fully recharges your active item at the start of each boss fight, Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Zaratus, Gives you the Holy Mantle shield effect at the start of every new floor, which protects you from the next hit of damage you take, Does not recharge until the start of the next floor, Stacks with the effects from Holy Mantle and Blanket, but it does not stack with Holy Card, Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by Ep and Mills, Using your active item while holding this trinket will drop it back on a pedestal on the ground, Also after taking damage, you have a very small chance to drop one of your passive items, One-time use active items will be consumed and not dropped, Added as part of the Afterbirth+ Booster Pack #1 and based on the Steam Workshop mod created by MarkusLeben and iguesti, *, yellow, golden, box, block, square, cube, Holding this trinket will cause the Angel mini bosses to drop normal items instead of Key Pieces, Added as part of the Afterbirth+ Booster Pack #2, designed by Edmund McMillen, While held, the last door Isaac went through stays open, allowing him to leave the room even if enemies are in it, This trinket works on boss rooms (except Ultra Greed) and devil rooms containing Krampus, allowing you to exit out mid-fight, UNLOCK: Unlock this trinket by blowing up doors and secret room walls 50 times, *, door, stop, wedge, cheese, wood, brown, hodor, game of thrones, Wylis, After being picked up, a yellow laser chain now flows through Isaac's familiars, Added as part of the Afterbirth+ Booster Pack #4 and based on the Steam Workshop mod created by Strawrat and Aczom, While held, spawns +1 friendly blue fly every time you pick up a coin, Added as part of the Afterbirth+ Booster Pack #5. PC 9SS3 3YXY (Second floor treasure room) (+ Technology 2 on third floor), PC GXSE V7P4 (Treasure Room adjacent to spawn), PC EZTZ CL68 (Treasure Room adjacent to spawn), PC RR0G KKQJ (Treasure Room adjacent to spawn), PC 6FDS 6FWF (Treasure Room adjacent to spawn), PC PCM8 R3H4 (Treasure Room adjacent to spawn), PS4 GXA1 L6XC (Treasure Room adjacent to spawn), PS4 27T2 26G0 (First floor Treasure Room), 3DS 11DA E0JZ (Treasure Room adjacent to spawn), Switch AL2T Q6NC (First Golden Treasure Room), Achievements Every 6 coins Bumbo will evolve to a new form except for level 4 which takes 12 coins, Level 2: Bumbo gains a body and crawls around the room, sometimes dropping random pickups, Level 3: It now fires tears in the same direction Isaac does, Level 4: Bumbo no longer fires tears but instead will chase enemies slowly and deal contact damage. Brimstone, probably one of the most iconic items in the franchise of The Binding of Isaac is also the item that got the most changes over the years and versi. This includes key blocks and secret room doors, +1.0 Damage Up, but each rock tear has a random damage modifier that can go up or down (x0.5 to x2), Allows Isaac to charge by double tapping the same direction, dealing damage to any enemies caught, You are invincible while charging (doesn't include self-damage like Blood Donation machines), The dash deals x4 your current tear damage + 8, Doesn't have to be in a straight line, you can hold another button to curve it, Has a 3 second cooldown before it can be used again, While not moving your speed rapidly increases up to a bonus of +0.5, While you have this +0.5 bonus, moving will cause Isaac to fart around the room, spawning poison gas clouds, The farts stop spawning once you reach your regular movement speed, Poison deals damage equal to half your tears per tick, Isaac is immune to Poison from enemies, such as Gasbag, Gives you a wide circle halo which grants 7 orbital tears upon entering a new room, The tears orbit for 13 seconds before dropping off, Has a chance to absorb any enemy tears and add them to the orbiting tears. Butt Bombs, Hot Bombs), When used will teleport you to another random room that has not been explored yet, After all the normal rooms have been explored, the hierarchy of rooms chosen is: Boss Room, Super Secret Room, Shop, Item Room, Sacrifice Room, Dice Room, Library, Curse Room, Miniboss, Challenge Room, Bedroom, Arcade, Vault, Secret Room, Devil/Angel Room, I AM ERROR, This ordering means a Devil and I Am Error room can both be forced if all others have been visited, If used in a normal room with enemies it will teleport you out and back into the exact same room, *, golden, yellow, robot, antenna, black, teleport two, teleport 20, Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it, The trail of black powder left on the floor will quickly disappear, meaning you are limited on the size of the pentagram symbol you can create, REPENTANCE - Black Powder's pentagram can now damage flying enemies, When used, applies the charm effect to any enemies in close range and deals 5 damage. REPENTANCE - This item was completely reworked for Repentance and no longer forces a random dice use each time. Blood Of The Martyr Damage Up. Each time you clear a room there is a chance a Red Room will spawn at one of the walls. No longer has an "on hit" effect, UNLOCK: Unlock this item by donating 999 pennies to the Shop, * shop room pool, shop item pool, stopwatch, blue, pocket, clock, Tears now revolve around Isaac's Body at a fixed distance until they hit the ground, Aiming in the opposite direction is often better due to how the tears circle around Isaac, Causes a lot of great synergies with items such as Lump of Coal, Brimstone, Rubber Cement, Technology and most of the worm trinkets, REPENTANCE - Tiny Planet's orbit now more tightly follows Isaac. Trinkets Chapters Curses Isaac's Heart Loki's Horns Bouncy Tears Homing Tears Tammy's Head Tiny Planet Tough Love The Wiz Incubus Epiphora Dead Eye Pupula Duplex Tractor Beam Evil Eye Dead Tooth Eye of Greed Glaucoma Eye of Belial Ghost Pepper Large Zit Rag Mega's Orbitals aren't affected by her shots. It appears as an alchemical symbol for sulfur. Characters Endings. Blood clotting becomes a problem when it blocks your blood . ( : Bum Friend The Peeper Ghost Baby Harlequin Baby Daddy Longlegs Sacrificial Dagger Rainbow Baby Holy Water Guppy's Hair Ball Abel), Others: 1UP The Virus Less Than Three Skeleton Key A Dollar A Quarter Boom! mario, cartridge, nes, grey, gray, orange, When used, rerolls each item you currently own into another item room pool item and any pedestal items and pickups in the room, Has the combined uses of the D4, D6 and D20, REPENTANCE - Full run reroll effects (such as D4) are now able to remove heart containers and transformations if losing the respective items during the reroll, UNLOCK: Unlock this item by beating Boss Rush with The Lost, * item room, treasure room, item room pool, deathstar, death star, dice pip, white, circle, sphere, When used, the D4 re-rolls each item you currently have into another random item from the same item pool, If you have an item with no room pool (e.g. A clot blocking blood flow to the brain can lead to a stroke. They can be used to damage enemies, Saturnus tears can't break objects such as poop and TNT barrels, Isaac now shoots ice tears that slow enemies. ( : IPECAC Tough Love Technology 2 Mutant Spider Epic Fetus Polyphemus Sacred Heart), Stat Ups: The Sad Onion Max's Head Number One Blood of the Martyr Magic Mushroom Roid Rage Raw Liver Lunch Dinner Dessert Breakfast Rotten Meat Wooden Spoon The Belt Mom's Underwear Mom's Heels Mom's Lipstick Wire Coat Hanger Steven Pentagram The Mark Growth Hormones Mini Mushroom The Pact Small Rock Super Bandage Robo-Baby Little C.H.A.D. Counts as 1 of 3 mushroom items needed towards the Fun Guy transformation. Monsters These damage increases do not stack with each other. Azazel- Azazel gets Brimstone, The Ludovico Technique, Cricket's Head, Demon Tail, and 1 red heart. Trinkets chalice, indiana jones, * angel room pool, god room pool, angel room item, bird, white, Every time you use this item it deals 40 damage to all enemies in the room and Isaac also takes damage, The first use per room takes 1 full heart, then 0.5 hearts per use after that, Shields and invincibility effects do not prevent damage when using this item, Using with Isaac's Heart previously prevented you from taking damage, however in Repentance this was fixed, Using this item as The Lost will instantly kill him, even if you have Holy Mantle active, UNLOCK: Unlock this item by beating Satan with Samson, * item room, treasure room, item room pool, razor, straight, edge, barber, bloody, brown, silver, Follows behind Isaac and can be swung back and forth, dealing 5 contact damage per tick to anything it hits, Every time the hairball kills an enemy, it grows in size allowing it to deal more damage, This is one of the items which allows you to transform into Guppy, Moving to a new floor decreases the size of the hairball, * devil pool, devil room pool, devil deal, grey, brown, pile, guppys hairball, guppy hairball, A familiar that mirrors the player's movements and shoots tears directly at Isaac, Abel's tears do 3.5 damage, unless playing as Cain in which case they do 5, REPENTANCE - Abel now has an increased rate of fire, and will mirror to the other side of the room, even if it's off screen. Rooms Items: Rocket in a Jar, Goat Head, Dead Cat, Soy Milk, Blood Clot. effect for 10 seconds. UNLOCK: Unlock this item by defeating The Beast as ??? UNLOCK: Unlock this trinket by defeating Greedier Mode with ??? UNLOCK: Unlock this item by beating Delirium on The Void floor with ??? If it touches an enemy it breaks and leave a pool on the floor which freezes enemies and deals 8 damage per tick, * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, Using active items gives a damage up that scales with the charge time, ??? Following the path takes you to an abandoned mineshaft, which leads you to a pedestal with the Knife Piece. Symptoms of a blood clot include: throbbing or cramping pain, swelling, redness and warmth in a leg or arm. From the creative mind of Edmund McMillen came a dungeon crawler inspired by The Legend of Zelda, loaded with . blue, glow, 69, Isaac increases in size, gets a lion's mane and now has the ability to crush rocks by walking over them, Crushed rocks and poop can fill holes if you walk in their direction, Allows you to crush Red Poops and sometimes not take damage. Can be used with Placebo to generate infinite batteries, Amnesia - Hides the floor map for the rest of the current floor (same as curse of the lost). Tears can still hit Isaac if gravity applies for too long, Allows Isaac to squeeze between some objects, This item has a chance to spawn an additional curse room on each future floor, Causes a penny to spawn in all future Curse Rooms, Tears fired from your left eye gain roughly +28% fire rate increase, Causes your tears to be fired at staggered rates, Allows Angel Rooms to appears even if a Devil deal has been taken before, All shops now contain a trapdoor with a ladder, which leads down to a special shop. After a few seconds a huge missile hits the target and deals 20x your tear damage to anything nearby, Essentially a one-time use of the Epic Fetus item, * item room, treasure room, item room pool, grey, gray, robot, Isaac's tears now have a piercing effect which allows them to travel through enemies instead of breaking on hit, * item room, treasure room, item room pool, arrow, penetrative, penetrating shots, grey, gray, 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, REPENTANCE - The damage tick rate on Big Chubby has been increased, 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. Monsters Objects You can force spawn a cracked key by droping any trinket in a Boss Room or Item room, on any floor on your way down to Depths II. This doesn't convert hearts that dropped before picking up this trinket, and doesn't apply to set heart drops, i.e. Unlocked from the 'Once more with the feeling!' Seeds pills in one run, 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, UNLOCK: Unlock this item by spawning 3 charmed enemies in a single room, 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. Chemical Peel is a passive item. ?, Satan and The Lamb as Tainted Magdalene, The first time you pick this trinket up, the heart container will be filled. Based on the Steam Workshop mod created by Niro, A familiar with a charged attack, that spawns a line of creep on the floor which damages enemies that walk over it, 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. ?, Satan and The Lamb as Tainted Cain, Spawns a sack at the start of each new floor, UNLOCK: Unlock this trinket by defeating Mother as Tainted Cain, Causes an Item Room and Shop to appear in Sheol, UNLOCK: Unlock this trinket by defeating 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, 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), 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, 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, *, red, white, stripe, hat, clown, waldo, wally, 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 item 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), 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, *, green, red, present, bow, xmas, christmas, 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, Allows you to rapidly place bombs on the ground, Added as part of the Afterbirth+ Booster Pack #1. Trinkets Rooms 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, If you have 40 bombs it will spawn 4 x Boom! This item has 75% lower chance to appear in. ?, 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. 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. Effects Isaac's touch now petrifies enemies, turning them to gold for a few seconds. UNLOCK: Unlock this item by defeating Delirium as Azazel, *, red, glow, Dark Prince's Crown, dark princes crown, dark prince crown, Gives you a 6.66% chance to fire a razor blade which deals x4 damage, 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, 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, REPENTANCE - Lead Pencil's tear barrage no longer deals double damage, 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, While firing, you gain a green aura that poisons any enemies which touch it. Item Pool Monsters This video showcases all blood clot familiar variants that can be created with the Sumptorium item in The Binding of Isaac Repentance. ?, Satan and The Lamb as Tainted Jacob, Gives you a familiar that follows Isaac's exact movements (similar to how Jacob & Esau work) and shoots spectral tears, Similar to Jacob and Esau, positions can be altered by running it into objects, or holding the drop button (Ctrl on Steam version), When you place a bomb, the Found Soul will drop one too, If it takes any damage, it will die and not respawn until the next floor, UNLOCK: Unlock this trinket by defeating Mother as Tainted Jacob, Everytime you use your active item, you have a chance to activate another random active item, Glowing Hourglass effect is blocked from this item, UNLOCK: Unlock this trinket by defeating Isaac, ?? While in this form you can walk over enemies to mark them for death. After a few seconds, he will quickly attack each target, chaining higher damage for each enemy it hits, UNLOCK: Unlock this item by defeating Hush and Boss Rush as Tainted Judas, When used this will cause 8 poison farts that leave a brown creep behind, and then drop 7 Butt Bombs very quickly, Standing in the creep gives you +1 Damage Up and +1.35 Tears Up, UNLOCK: Unlock this item by defeating Hush and Boss Rush as Tainted Blue Baby, For the current room, 14 Dead Birds fly in from off the screen and attack all enemies, dealing low but frequent damage, UNLOCK: Unlock this item by defeating Hush and Boss Rush as Tainted Eve, Isaac gains the Berserk! Flies spawned from a Mulligan dying, When used, the Mega Bean will freeze all enemies in the current room for a couple of seconds, deal 5 damage and poison any enemies in close proximity and send a wave of spikes across the room in the direction you are facing, The enemies in close range will take 5 damage then have a poison over time effect which deals your tear damage 4 or 6 times, The spike wave will deal 10 damage to any enemies in contact with it. Item Tags Deals 45 damage to enemies it lands on. It leaps at enemies, dealing contact damage and firing quad shots at them for the rest of the room. Each secret room contains a beam of light, that gives half a soul heart, and a Tears Up for the rest of the floor. Manage all your favorite fandoms in one place! pink, purple, Spawns a familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one, The Leech deals 1.5 contact damage per tick, * item room, treasure room, item room pool, grey, gray, worm, A bag that follows Isaac and drops a random heart, coin, bomb or key every 5-6 rooms (alternating, 5 rooms then 6, then repeats), Can drop any kind of heart, coin, bomb or key, UNLOCK: Unlock this item by beating the Dark Room with Eden, Item Pool: Item Room, Beggar, Secret Room, * normal beggar pool, normal judgement pool, coin beggar pool, coin judgement pool, secret room pool, item room, treasure room, item room pool, mysterious sack, multiple sacks, bag, pouch, purple, question mark, A large familiar black fly that bounces around the room, exploding on contact with enemies dealing 70 damage, Does not explode if it hits Isaac, however if it explodes on an enemy while Isaac is in range, he will take damage, Respawns after 10 seconds or by moving to another room, * item room, treasure room, item room pool, heart, smile, A green brain that launches in the direction you are firing your tears and will explode on contact with enemies, dealing damage and poisoning anything in the blast radius, Bob's Brain deals 100 damage and applies a poison damage over time effect, which deals double your tear damage per tick, Will hurt Isaac if he is in the blast radius. 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