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, Item Pool: Shop, Devil Room, Curse Room, Red Chest, Demon Beggar, When used, the D1 duplicates 1 random pickup in the current room. Unlockables can be viewed by going to the "Stats" section in the main menu, and then viewing "Secrets" in the left-center of the screen. This doesn't work with The Lost characters, While in a room with enemies, red cracks will appear on the floor in random locations, Walking over the crack spawns a white soul familiar, that launches itself into the nearest enemy, exploding and dealing double your tear damage to everything near it, Cracks will keep appearing but only one can exist in the room at a time, UNLOCK: Unlock this item by defeating challenge #38 (Baptism by Fire), While held, this item spawns a familiar that can be moved around using the arrow keys and deals 1.5 damage per tick to any enemies it touches, When activated, you teleport, swapping places with wherever Stitches was positioned, Teleporting next to fires will extinguish them (including blue fires) and on top of shopkeepers will destroy them (gives +10% devil/angel room chance as normal), If used while stitches is on top of an enemy, it can be used to telefrag enemies, dealing x3.5 your damage + 40, Can be used to enter/exit Curse Rooms for free by teleporting infront of the door while holding the direction key to move in immediately. Also summons a blue crosshair which can be moved around freely. rocks), Item Pool: Item Room, Devil Room, Greed Mode Devil Room, * item room, treasure room, item room pool, luigi board, weeja board, paper, grown, Automatically gives you 1 bar of charge after using your spacebar item, Fully recharges your current spacebar item when picked up, Any items which are normally a 1 room recharge are now timed instead, * shop room pool, shop item pool, battery, black, brown, When Isaac takes damage, the dead bird will spawn and attack nearby enemies in the current room for 2 damage per tick, * item room, treasure room, item room pool, the lost item pool, starting, grey, gray, Tears are replaced with the ability to charge and fire a powerful laser that travels in a straight line across the room, dealing a lot of damage (tear damage hits for 9 ticks per laser) to any enemies it comes into contact with, Does not directly affect your Damage stat but hits enemies 9 times per charge, Synergizes very well with a lot of items including Tammy's Head, Tiny Planet, Inner Eye (Triple Shot), Mutant Spider (Quad Shot) and many others, If you somehow manage to get a second Brimstone, the laser becomes massive and deals double damage, * devil pool, devil room pool, devil deal, infinity, red, black, Has a chance to drop while playing any Blood Donation machine, UNLOCK: Unlock this item by playing the Blood Donation machine 30 times, Item Pool: None (Blood Donation machine only), Gives you a high rate of fire in exchange for a damage down, * secret room pool, item room, treasure room, item room pool, Thin Odd Mushroom, brown, purple, grey, gray, REPENTANCE - Odd Mushroom (thick) is now a larger damage increase (equal to that of Steven/Pentagram), but now also a larger speed downgrade (from -0.1 to -0.2), * secret room pool, item room, treasure room, item room pool, purple, pink, brown, thick odd mushroom thick, When you only have half a red heart remaining or less, you enter a curse state which adds +1.5 damage and +0.3 speed, When playing as Eve, this item activates with one FULL heart remaining or less AND also removes her 0.75 damage multiplier, raising it up to 1.0, The effect is permanently active for characters with no red hearts (e.g. - Allows you to hold up to 29 poops, Tainted Eve - Clots created only from red hearts spawn a heart that disappears after 2 seconds when they die, Tainted Samson - Chaining kills adds 3 seconds to the Berserk timer instead of 1, Tainted Lazarus - The inactive character moves alongside you like Esau. in shops or devil rooms), The only way to survive the falling sword is either through extra lives, by using items that would make you invincible, such as Gnawed Leaf or playing as The Lost. When used in the backwards path after picking up Dad's Note, R key will skip you to the Basement 1 version of this path, which leads directly to the Home floor. If you complete bosses as Azazel, your devil deals will be stronger. While held there is a small chance when using a tarot card or pill that a copy of it will be dropped on the floor next to you, +0.2 Damage Up for each 'evil' item you have, Items classed as evil in this case are Black Candle, Ceremonial Robes, Abaddon, Goat Head, Match Book, Missing Page 2, Safety Pin, UNLOCK: Unlock this item by beating Greed Mode with Eve, Invincibility lasts longer after getting hit (Increased i-frames), This makes it possible to use the Blood Donation machine twice from one hit of damage, UNLOCK: Unlock this item by beating Blue Womb (Hush) with Samson, *, bandana, sling, white, knot, blindfold, +15% chance to get a double item room to spawn on the next floor, If the effect activates, two items spawn in your item room, however only one can be taken (Same effect as the More Options item), The chance doubles to +30% with the effect from Mom's Box, Automatically opens all shop room doors for free, UNLOCK: Unlock this trinket by donating 666 coins to the Greed Donation Machine, UNLOCK: Keeper starts with this trinket after beating Satan with Keeper, Forces the Greed and Super Greed mini bosses to no longer appear in shops or secret rooms, Holding Rib of Greed increase your chance to receive coin drops, UNLOCK: Unlock this trinket by beating Ultra Greed with Keeper, Donating to a Donation Machine has a chance to heal Isaac for a full red heart or spawn a Beggar, UNLOCK: Unlock this item by beating The Lamb boss with Keeper, Destroying poops now gives you a blue fly, While held, you heal for half a red heart every time you use a key to open a door or golden chest, Changes all half red hearts into full hearts, Hearts dropped from Tainted Magdalene's mechanic will be always full red hearts, *, red, brown, grey, gray, necklace, moms locket, mom locket, While this trinket is held you have a significantly lower chance to find spacebar/active items, It will cause passive items to spawn except when the game cannot generate any more passive items and will then instead choose spacebar/active items, Some hard coded spacebar items from bosses and mini-bosses (i.e. ?, Satan and The Lamb as Tainted Blue Baby, Drops 2 bombs at once (only 1 bomb is removed from your total), UNLOCK: Unlock this trinket by defeating Mother as Tainted Blue Baby. 5 Boss Secrets That ALL Players Need To Know! (Blue baby), *, dead, blue, face, fates reward, fate reward, A familiar chest that follows Isaac and has a 25% chance to drop a pickup after clearing a room, Possible drops include hearts, coins, bombs, key, pills, card, runes, batteries, trinket, UNLOCK: Unlock this item by beating Greed Mode with Isaac, Item Pool: Item Room, Greed Mode Item Room, Beggar, An orbital angel which does 7 contact damage per tick and blocks shots, The angel will attract bullets towards it and block them, Sworn Protector will drop an eternal heart if it blocks 10 shots in one room. After which, the only way to access an Angel Room is via the Sacrifice Room, * curse room pool, red chest pool, red chest item pool, golden chest pool, gold chest pool, devil pool, devil room pool, devil deal, brown, horns, When depleted, Black Hearts deal 40 damage to the entire room, in a Necronomicon style effect, * curse room pool, demon beggar pool, demon judgement pool, devil beggar pool, devil pool, With Keeper's buff of an additional Coin Heart, unlocking this item isn't that difficult compared to what it would have been in AB+. After a minute or so of not hurting her she will fly away and spawn Plum Flute, UNLOCK: Unlock this item by allowing Baby Plum to escape instead of killing her, Spawns a star with a white aura around it, that floats very slowly through each room on the floor, making its way towards the boss room, While standing inside the aura, you gain a big Tears Up (x2.5 fire rate), Damage Up (damage * 1.2 + 1) and homing tears, The star continues to make its way through the floor, even if you aren't in the same room as it, moving faster if you are a long distance ahead of it, On The Void floor, it will move towards the boss room containing Delirium, Doesn't travel into the Hush or Mega Satan boss room, It may travel through secret/curse rooms on its route to the boss room, Counts as 1 of 3 astrology items needed in the same run to unlock Planetariums, UNLOCK: Unlock this item by defeating Delirium as Bethany, Gives you a baby in an ice cube, which can be kicked around the room by walking into it, Enemies take damage from Cube Baby depending on how fast it was travelling when it hit them. This is a one-time use of the Red Key item. the eternal hearts that drop in angel themed super secret rooms, All heart drops from Ace of Hearts will be Black Hearts, UNLOCK: Unlock this item by beating Satan with Azazel, *, black, devil, pointy, daemons tail, demons tail, demon tail, Dying in a sacrifice room while holding this trinket will unlock The Lost character, After The Lost is unlocked, dying anywhere with this trinket will bring you back to life as The Lost and the trinket will be deleted, When playing as Tainted Lost, you don't swap to being regular Lost, it simply acts as an extra life, UNLOCK: Unlock this item by beating Dark Room with Isaac, Everytime you pick up a coin, you fart, inflicting poison damage to nearby enemies, Greatly increases the chance of coins dropping from poops, Tears now move forwards at right angles, shifting left and right across the room, Increases your range stat by +10.0 while held but due to the fire pattern, your tears travel a similar distance to normal, Your tears now whip across the room at a very high shot speed, Shot speed gives your tears more effective range, but doesn't increase your range stat directly, Has a 22.22% chance to respawn with 3 Soul hearts as Blue Baby when you die, UNLOCK: Unlock this item by beating Satan with Lazarus, Everytime Isaac takes damage, one blue fly will spawn, * , the lost item pool, green, red, bloody, dead, Isaac's tears have a chance to poison enemies, The poison effect leaves a damage over time, which deals 4 or 6 damage per tick, The chance to poison enemies is affected by your luck stat and at +18 Luck it will activate every time, Isaac now has a chance to make a spectral and piercing tear, The chance to fire a piercing tear is affected by your luck stat and at +18 Luck it will activate every time, While held, this trinket gives a random mushroom effect each room, Possible mushrooms include: Mini Mush, Odd Mushroom (Thin), Odd Mushroom (Thick), The Compass, *, ping, pong, paddle, grey, gray, mushroom, While at 1/2 a red heart of health, you gain a Little Steve familiar that follows you and shoots homing tears, REPENTANCE - Umbilical Cord now has a high chance to spawn a Gemini familiar for the room when Isaac takes damage. Returning back through the mirror door returns you back to normal again. Taking it will cause Mom's Shadow to spawn and chase you. The effect is shown visually in 3 stages with the character's belly getting larger each time until it finally gives birth to a familiar. ), UNLOCK: Unlock this item by defeating The Beast as Tainted Eden, *, tm trainer, glitched items, glitch item, tmt trainer, tmelt, t melt, When used, it puts the closes enemy in chains for 5 seconds, preventing it from moving. Sales can be randomly applied just like regular shops, The ladder disappears after leaving the starting room, even if you haven't used it yet, In Antibirth this was called Jacob's Ladder, which had to be renamed as Afterbirth+ already had an item with this name, UNLOCK: Unlock this item by defeating Isaac as Jacob & Esau, Permanently shows the location of the boss room on the map, After defeating the shown boss fight, this item will activate a use of the Sun card (full heal and map reveal), fully recharge your active item, remove curses from the floor, gives +3 Damage Up and +1 Luck up for the rest of the floor, Only available inside a Planetarium - a room that has a base 1% chance to appear, which increases by +20% every time you skip an Item Room (Must not enter to count as skipped), In The Void floor it shows a random boss room, which isn't necessarily Delirium's room, Adds one extra secret room and one extra super secret room to each floor. 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