. While firing tears the water will be fired as a projectile across the room. * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, The longer the button is held the faster Gurdy will fling itself across the screen, Deals a fixed amount of damage depending on charge level, at lowest being ~5 and at max being ~20, Lil Gurdy bounces off of enemies and obstacles, A beggar head which floats around the room and picks up any nearby coins. Gives Isaac a little portal familiar, that moves across the screen as you're firing, The portal will suck up any consumables and trinkets it travels over, causing it to become larger and deal more contact damage, When the portal sucks up 4 pickups, it turns into a portal that can be used to teleport to unexplored rooms around the floor. * golden chest pool, gold chest pool, item room, treasure room, item room pool, green, ball, Dead Bird) then Box of Friends will cause it to spawn but won't create duplicates, This can be used multiple times in the same room to generate more familiars, meaning you can get a level 4 meatboy or bandage girl by using this item 3 times in the same room, If used when you have no familiars, it will give you a Demon Baby temporarily, UNLOCK: Unlock this item by beating Greed Mode with Lilith, Isaac wears a dunce hat and fires 2 tears at once diagonally, similar to the R U A WIZARD pill tear pattern, * Item Room, Greed Mode Item Room, dunce cap, white, hat, cone, Replaces Isaac's tears with nails, which have increased knockback, The increased knockback will also affect Brimstone, which usually has no knockback at all, Gives you a familiar demon incubus that follows you and shoots tears that scale with your own tears in terms of damage, stats and also effects, It will mimic any tear effects you currently have and also copy your current stats, meaning it will fire with the same damage, fire rate and range, Incubus' damage is reduced by 25% when playing as characters other than Lilith, UNLOCK: Unlock this item by beating Blue Womb (Hush) with Lilith, Item Pool: Devil Room, Greed Mode Devil Room, A familiar blue head that will follow Isaac and fire tears copying his tear damage and effects, This familiar is very similar to Incubus, however it only copies damage and is not affected by tears or range upgrades, UNLOCK: Unlock this item by beating Blue Womb (Hush) with ??? One of the following messages may show: "Some doors require a blessing. This effect can't be abused - next time it will be empty if dropped, UNLOCK: Unlock this trinket by defeating Mother as Tainted Magdalene, Every 15 shots you will shoot an Ipecac + My Reflection shot, The tear will fly in the air for about 3 seconds and follows Isaac until it falls and explodes. Instead of slogging through the main game and hoping the RNG rewards. - The Binding Of Isaac: Repentance #50; DOUBLE DEATH (CERTIFICATE)! 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. It will hunt down other enemies, dealing contact damage which scales with your tear damage, After 5 seconds the red soul explodes (Isaac doesn't take damage from this effect), UNLOCK: Unlock this item by defeating The Beast as The Lost, *, this item is irrelevant 99.94% of you wont kill the beast as the lost me included :(, When used, gives you number of blue flame orbitals based on the number shown over this item, It starts at 1, and increments each activation, giving you more familiars each time you use it, The flames fire tears at the same time Isaac does, that deal a flat 3 damage, If a flame touches an enemy, it deals contact damage equal to double your current tear damage and then disappears, You can have a maximum of 24 flame orbitals at once, Each flame has a chance to spawn as one of many variants, such as green flames that poison enemies, or a crucifix flame that spawns a random horseman familiar + Locusts when it is extinguished, UNLOCK: Unlock this item by defeating The Beast as Bethany, Soul hearts give you small permanent stat increases when picked up, Possible stats include +0.3 Range Up, +0.2 Luck Up, +0.2 Damage Up, +0.1 Tears Up, +0.04 Speed Up, UNLOCK: Unlock this item by defeating Greed Mode as Bethany, Spawns a random charmed enemy which fights by your side and copies your exact movements, similar to how Jacob & Esau work, The familiars fire tears at the same time as Isaac, and have a visible health bar showing how much damage they can take before dying, UNLOCK: Unlock this item by defeating The Beast as Jacob & Esau, You respawn as a tiny version of Isaac, with a greatly reduced hitbox and +0.2 Speed Up, When the effect activates you deal 35 damage to nearby enemies, Once unlocked, if you have already unlocked the tainted version of the character you're playing as, Inner Child is guaranteed to spawn in the hidden closet on the Home floor, UNLOCK: Unlock this item by defeating Greed Mode as Jacob & Esau, Item pedestals now cycle between 5 random items, UNLOCK: Unlock this item by defeating The Beast as Tainted Isaac, Enemies that touch Isaac will now bounce off him and fly off in the opposite direction, Bounced enemies will take 10 damage if they slam into the wall, This item also gives a random chance for enemy shots to bounce off you without taking damage, UNLOCK: Unlock this item by defeating The Beast as Tainted Magdalene, 33% chance to reroll items with a quality of 2, Quality is a hidden mechanic in Repetance for all items and ranges from 0-4. When used, turns every normal enemy in the room into poop! The beams of light now trail behind Isaac when charging with it (damage formula of the beams is damage * 4 + 10). 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, 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, 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, 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 Monstro's tears each deal base damage (3.5) and don't scale with damage upgrades, *, head, cleft, lip, palate, hairlip, tooth, A baby familiar that follows you and causes other familiars to follow it. The first piece drops by beating the first floor boss within 1 minute then bombing the shadow in the first room. The pick-ups which are NOT items, are the Pills, Tarot Cards and Trinkets. 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. 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. See next icon for Tainted character effects, Isaac - All new pedestal items cycle through two options. In exchange it gives you +0.05 Speed Up and Damage Up for every half a heart this item removes, The amount of Damage Up is (0.15 * FullHeartsRemoved ^ 2), If Isaac is already at half a red heart when stabbed, no damage or speed increases are given, The damage from being stabbed can be avoided with invincibility, however no damage or speed stat increases are gained if you do, Your individual tears each gain a random effect from either: Poison, Fear, Slow, Freeze, Charm, Burning, Homing, Bleeding, x2 Damage or Reduced damage, Allows you to walk on harmful floor effects without taking damage (e.g. Recharge Time: 6 rooms. ?, 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, ?? Blood Bag) it will be rerolled into a random Item Room item, Cannot remove Azazel's Brimstone laser, or The Lost's Holy Mantle, REPENTANCE - Full run reroll effects are now able to remove heart containers and transformations if losing the respective items during the reroll, UNLOCK: Unlock this item by blowing up 30 slot machines, * item room, treasure room, item room pool, dice pip, starting, pyramid, green, triange, When used, 'devolves' all enemies in the room which are currently alive into another weaker type of enemy, * item room, treasure room, item room pool, DIO, dice pip, orange, brown, turban, When used, copies the effect of the card you are currently holding without consuming it, The charge time of this item depends on the quality of the card you're holding, Using this with the ?
The Binding of Isaac: Repentance Tainted Characters Guide Every Item in The Binding of Isaac: Repentance - Platinum God Mysterious Item ID's: 59, 235 and 263 There are 547 items in the game (AB+), according to the wiki, the in-game collection page and platinumgod. ), 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, 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, * back in black, ac/dc, bag, brown, pouch, pocket, bulge, Gives you an extra heart container for every 25 coins you are currently holding, up to a maximum of 4 extra HP at 99 coins held, If your coin counter goes below the required amount for a heart container, you will lose it again, This item works for the Keeper, allowing him to exceed his usual 2 health containers, However, if Keeper drops to under 2 health coins as a result of Greed's Gullet, he is unable to use a HP Up to increase his health back to 2, and has to regain the lost coins to do so, UNLOCK: Unlock this item by beating Challenge #35 (Pong), *, dollar, cash, sack, bag, pouch, greeds gullet, greed gullet, 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, While firing tears you have a 5% chance to fire a void tear. Using this card will also open a pathway of red rooms back to the regular floor, UNLOCK: Unlock this card by defeating Ultra Greedier mode as Tainted Jacob, "May the darkness swallow all around you", When used, grants +1.5 Damage Up, turns your hearts to Bone hearts and the Spirit of the Night effect (Spectral tears and the ability to fly) for the current floor, Also gives the Curse of Darkness effect that can't be removed for the current floor, UNLOCK: Unlock this card by defeating Ultra Greedier mode as Tainted Lazarus, Creates a trapdoor to a guaranteed crawl space, UNLOCK: Unlock this card by defeating Ultra Greedier mode as Tainted Eden, When used, this copies the effect of the card, pill, rune, soul stone or active item you used most recently, UNLOCK: Unlock this card by defeating Mega Satan as Tainted Eden, Turns all pedestal items in the current room into rotating items, which cycle between the old item and a random new item every second, This allows you to effectively reroll items like with The D6, but choose the old item as well if you want, Tainted Isaac has this effect passively for all items, If you use more than one in the same room, each pedestal item will cycle through +1 random item, Items are chosen from the item pool related to the current item, UNLOCK: Unlock this item by defeating Hush and Boss Rush as Tainted Isaac, When used, all enemies in the current room drop half a red heart that will disappear after 2 seconds if not picked up, UNLOCK: Unlock this item by defeating Hush and Boss Rush as Tainted Magdalene, When used, this Soul Stone creates Red rooms for every possible exit in the current room, Red outlines of doors appear where this Soul Stone will create exits for, See the Red Key item description for more information about these Red rooms behave, UNLOCK: Unlock this item by defeating Hush and Boss Rush as Tainted Cain, Activates the Dark Arts item effect, which turns Isaac into a ghost for a few seconds. The room doors will open if only frozen enemies remain, UNLOCK: Unlock this trinket by defeating challenge #41 (Pica Run), Every time you kill an enemy you get an invincibility shield for 1 second, While shielded, each enemy killed adds +1 seconds to the duration, UNLOCK: Unlock this trinket by defeating challenge #37 (Bloody Mary), Teleports the player to the first room of the current floor, There is a guaranteed Fool card in the Depths 2, if you bomb the skull with an X on it. Any Tarot card or rune on the floor or current held when picking this item up will change into a pill, Dice Shard counts as a card and will be converted, UNLOCK: Unlock this item by picking up 2 of the following items: Roid Rage, The Virus, Growth Hormones, Experimental Treatment or Speed Ball, * shop room pool, shop item pool, brown, purple, * boss room pool, boss room item, red, wedge, purple, triangle, The above stats only apply to tears fired from Isaac's left eye or with a 50% chance if you have an item which causes you to fire from a single source only, * boss room pool, boss room item, red, blob, circle, spot, * boss room pool, boss room item, grey, gray, Enemies touching placed bombs take 16 damage, Gives all bombs a burning effect when they explode, leaving fire on the floor which deals 22 damage to enemies, REPENTANCE - Hot Bombs now have greatly increased contact damage (increased from 1 to 16), and passively grants Isaac immunity to fire, * item room, treasure room, item room pool, fire, orange, flame, face, Isaac's tears now set enemies on fire, leaving a damage over time effect that does 4 or 6 damage per tick, There is a chance that tears that hit enemies will explode, leaving a small fire on the floor that damages enemies, Exploding tears deal damage * 2 + 22 per tick, The chance for tears to explode is affected by your luck stat and at +13 Luck it will activate every time, * item room, treasure room, item room pool, fire, flame, orange, back, ball, burning, When picked up, and at the start of each floor this rerolls all your current items, giving you a new item to replace each of the ones you had, Also rerolls all your stats at the same time, giving a random flat modifier that changes each time, Doesn't affect important items such as Polaroid, Negative and Key Pieces, UNLOCK: Unlock this item by beating Boss Rush with Lazarus, * secret room pool, mondrian, painting, yellow, blue, red, white, Tears now have a chance to apply the fear effect to enemies, which causes them to run away from Isaac, The chance to fear enemies is affected by your luck stat and at +20 Luck it will activate every time, An item only found in the devil room pool (Note: The Fallen boss pulls items from the Devil Room Pool), * devil pool, devil room pool, devil deal, grey, gray, fist, glow, Immunity to all floor curses (e.g. Use the arrow keys or WASD keys to move around. Stat Down becomes Stat Up. Increases the maximum heart limit to 18. smile, lil' brimstone, Prevents Isaac from taking any damage, but instead summons a familiar heart that follows you around. debug 1 - Displays hitboxes of objects. Tears are now white, do a lot more damage and move slower across the screen with a homing effect, * angel room pool, god room pool, angel room item, red, fire, flame, orange, cross, Does not increase your damage, simply makes your tears red, * boss room pool, boss room item, sticks, brown, yellow, * angel room pool, god room pool, angel room item, the lost item pool, cup, wooden, gold, in a small boss room), UNLOCK: Unlock this item by defeating Greedier Mode with Lilith, 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. gray, horns, Tears are replaced with a knife which can be charged and thrown in a boomerang style action, The knife can also do damage without being thrown as a close range melee weapon, When used as a melee weapon, Mom's Knife deals your tear damage * 2 per tick, At the furthest point from Isaac the knife deals your tear damage * 6, UNLOCK: Unlock this item by beating Satan with Isaac, Item Pool: Item Room, Devil Room, Challenge Room, Mom's Chest, * dungeon room, blood challenge room, arena pool, devil pool, devil room pool, devil deal, item room, treasure room, item room pool, grey, gray, silver, Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e.
How do you spawn/create an item pedestal? : r/themoddingofisaac - reddit This chance doesnt change if you take further damage, You effectively have a 4.4% chance for every minute that passes after taking damage to die, Self-inflicted damage i.e. They also no longer block player attacks or get extinguished by them, UNLOCK: Unlock this item by donating 400 pennies to the Shop, Isaac can now pick up hearts while at full health, which will be stored in the Jar and can be spawned again using the spacebar, Soul hearts and black hearts cannot be stored, If used in a Black heart or Eternal heart super secret room, it will spawn the relevant heart, * shop room pool, shop item pool, the lost item pool, glass. effect for the floor, UNLOCK: Unlock this item by beating Satan with Eden, Item Pool: Item Room, Library, Secret Room, * library pool, library room, book room pool, secret room pool, item room, treasure room,
The Binding of Isaac: Rebirth Price history SteamDB . The damage formula of the bombs has changed from damage * 5 + 30 to damage * 10, UNLOCK: Unlock this item by beating Mom's Heart 9 times, * item room, treasure room, item room pool, baby, fetus, foetus, jar, white, pink, bug, dr fetus, Causes pickups on the floor move towards the player, Works across pits, but not through Key blocks, REPENTANCE - Magneto is now capable of opening chests from a small distance. 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. 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, For example, an item which usually gives +1 Damage would instead give a small 'all stats up', Stats effected by this item are: Damage, Tears, Range, Speed, When taken with another item which gives an extreme value in a certain stat (e.g. ), Prevents your stats from being reduced any more for the rest of the run, e.g. D6, D20 etc.
Rock Bottom - Binding of Isaac: Rebirth Wiki The item is between Big Chubby (473) and Plan C (475) horizontally. This effect is stackable, *, the lost item pool, pink, red, guts, intestine, tube, Gives Isaac a higher chance to find hearts from drops after clearing a room and from chests, * , the lost item pool, red, purple, childs heart, child heart, UNLOCK: Unlock this item by beating the Dark Room with Judas, Gives Isaac a higher chance to find keys and chests, Grants a secondary chance of any non-specific heart drop turning into a soul heart, * , the lost item pool, white, grey, gray, circle, round, moms pearl, The fire rate increase is applied in such a way that the higher your tear stat is, the more effective Cancer is, Breaks the normal fire rate cap, allowing you to fire faster than the normal maximum, You have a chance when taking damage to gain +1.8 Damage Up for the rest of the room, Gives Isaac a higher chance to find bombs, Picking up the Match Stick is the only way to remove the Tick trinket, UNLOCK: Unlock this item by blowing up 20 shop keepers (this includes the ones in the secret room), When you take damage while on 1/2 a heart, you are teleported back to the previous room. Unlocked from Challenge #24 - PAY TO PLAY, Friends till the end - Spawns three friendly blue attack flies, Infested! Join. * angel room pool, god room pool, angel room item, item room, treasure room, item room pool, * secret room pool, item room, treasure room, item room pool, 25, grey, gray, silver, devil pool, devil room pool, devil deal, Converts most negative pills into their positive counterparts, e.g. When an enemy touches the halo for couple of seconds, a beam of light will come down and deal a burst of damage to it, The triggered beam also fires in all 4 cardinal directions, dealing damage to anything it touches, Every time Isaac takes damage, the halo grows slightly bigger up to a maximum of 10 times. See the dedicated Devil room page for more details, First half of the key required to enter the door to the Mega Satan boss, Drops from one of the angels which appear by bombing the statue in an angel room, * angel room, angels, broken, yellow, gold, circle, Second half of the key required to enter the door to the Mega Satan boss, Randomly increases 4 of your stats, and decreases 2 of them, Possible stat changes are fixed values: 1 health, 1 damage, 0.2 speed, 0.5 range, 0.5 tears, 0.2 shot speed, 1 luck, UNLOCK: Unlock this item by beating Mom's Heart 7 times, * demon beggar pool, demon judgement pool, devil beggar pool, boss room pool, boss room item, item room, treasure room, item room pool, yellow syringe, needle, injection, Doubles pickups and chests from clearing a room, Also gives a 30% chance for room clear rewards to not spawn, Doesn't affect coins spawned in Greed Mode, * curse room pool, demon beggar pool, demon judgement pool, devil beggar pool, devil pool, Based on the Steam Workshop mod created by electoon and Erfly, *, dark side of the moon, rainbow, red, yellow, green, white, triangle, pink floyd, thought, 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. The chance for this effect to activate depends on your Luck stat. Frozen enemies can be pushed into obstacles where they shatter on contact and fire ice shards around them. Cain - +1 Luck. After taking two hits, the fire will be extinguished, The Book can be held at the same time as another active item. red, drip, Isaac's health is set to 1 and he also gains 9 extra lives, Each time Isaac dies, he will respawn with 1 Health, Has a chance to drop from the Super Pride mini boss, The floating Dead Cat head that follows you will disappear when you are on your last life (Very useful for The Lost), Counts as 1 of 3 cat items needed towards the Guppy transformation, Item Pool: Devil Room, Curse Room, Red Chest, Super Pride Miniboss, * curse room pool, red chest pool, red chest item pool, devil pool, devil room pool, devil deal, Gives Isaac demon wings and the ability to fly. This mod adds text to the screen that describes the effects of every item in the game - pedestal items,. Based loosely on the Steam Workshop mod created by Extreme Ninja Home Makeover with changes by Edmund McMillen, *, lepracy, leprasy, leprosy, pink, red, bloody, lump, Gives you a random Harbinger familiar that changes every 10 seconds, Each harbinger behaves differently, based on any of the original 5 horsemen bosses, REPENTANCE - The harbingers will also randomly spawn their relevant Locust variant. Placing a bomb this way will not affect your devil/angel room chances, Lil Dumpy follows Isaac and produces a Butter Bean fart when a projectile or enemy is about to hit Isaac, pushing the enemy back and preventing the damage, After it farts, it flies away, stops following Isaac and has to be picked up again before it will follow again, He also has a second larger detection radius that can randomly trigger from enemy projectiles, The effect only works if Lil Dumpy is following and near Isaac, You have a chance alongside each tear to shoot a red flame, which deals damage to enemies that come in contact with it, Damage starts at x4 your current tear damage, and scales down each time an enemy touches the fire, The chance to create a fire scales with your Luck stat, at +11 Luck you have a 50% chance to shoot one, The flames from this item can destroy shopkeepers, which is handy since doing this once per floor increases your devil/angel room chances slightly. They modify Isaac's Attributes, grant or modify Tear Effects, and much more. For Items it increases by 2 coins * the number of purchases. Midnight Snack = +1 flat damage, +1 luck. ?, Satan and The Lamb as Tainted Eve, A small clot friend will hug Isaac, following his exact movements (similar to how Jacob & Esau work) and shooting tears when he does, The clot can be moved around by collision with an object/wall, allowing you to re-position it, The clot's damage is roughly 1/3 of your tear damage, If it takes a few hits it will die, and respawn in the next room, UNLOCK: Unlock this trinket by defeating Mother as Tainted Eve, Spawns a random chest after completing a regular Challenge Room, Spawns a pedestal item after completing a boss Challenge Room, UNLOCK: Unlock this trinket by defeating Isaac, ?? you can wish list it on steam here > mewgenics.com more info dropping on Halloween! shop room pool, shop item pool,red, robot, head, cube, REPENTANCE - This item has been reworked. Bad Trip becomes Balls of Steel. Based on the Steam Workshop mod (originally called Hungry Tears) created by Echo, UNLOCK: Unlock this item by taking 10 Tears Up items or pills in the same run, 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. Picking up Bone Hearts while at 12 hearts will remove charges from the Box, UNLOCK: Unlock this item by defeating The Lamb as Bethany, Spawns a ladder in the starting room of all future floors, which leads to an Angel Room, Angel rooms accessed by The Stairway are different - They sell angel room items and soul hearts for money, similar to the Shop, Pedestal items cost 15c, all other items (eternal/soul hearts, keys and holy cards) cost 5c.