Binding of Isaac Afterbirth Plus Item Cheat Sheet (2024)

Dark Princes Crown

ItemID: 442

"Loss is power"

Apple!

ItemID: 443

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

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

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

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

*,