Effect: If used without holding any "Act" passive item (see below), rerolls item pedestals in the room to a random Act. This does not work in the Shop or Devil room.
While held, has a chance to replace any item pedestal with a random Act of the Apostles, which each give additional benefits to this item:
Act I - One use, increases one of Isaac's six major stats until entering a new room
Act II - On use, prevents contact damage from non-boss enemies until entering a new room
Act III - Upon dying, revives Isaac with full health and removes this item
Act IV - On use, heals Isaac two red hearts
Act V - On use, will revive Isaac with one Soul Heart if he dies in the current room
Act VI - Passively increases chance to receive an Angel or Devil room at the end of the floor
Act VII - On use, grants Strange Attractor tears until entering a new room
Act VIII - On use, decreases Size until entering a new room
Act IX - On use, increases Speed until entering a new floor
Act X - Reduces the prices of pick-ups, and sets maximum item price outside of the Shop to 20 Coins
Act XI - On use, resets Isaac's chance to receive a Health Upgrade at the end of the floor
Act XII - On use, increases chance to receive an Angel or Devil deal to 100 percent; this is reverted upon entering a new room
Act XIII - On use, grants Flight until entering a new floor
Act XIV - On use, kills all non-boss enemies in the room, but deals one full heart of damage to Isaac
Act XV - On use, activates a random 'holy' book
Effect: Causes Isaac to fire tears that have increased knockback and fall suddenly at the end of their range
Effect: At the start of each floor, randomly increases one of Isaac's six major stats based on the number of rooms available on the floor
This item may only spawn after collecting both Alpha and Omega, and removes these items from the player.
Effect: In addition to the effects of both Alpha and Omega, grants Flight and a small bonus to stat increases gained from the aforementioned items
Effect: Provides various mapping effects based on Isaac's filled red health:
At three hearts or less, reveals secret rooms
At four hearts or more, reveals secret and special rooms
At six hearts or more, reveals the entire map and prevents Curse of the Lost
Effect: Massively increases Damage; this bonus is reduced for each collectible Isaac has
Effect: Grants the Stompy effect
Effect: All standard coins that spawn are replaced with their double variant
Effect: All standard keys that spawn are replaced with their double variant
Effect: Increases Fire Rate until Isaac enters a new room
This item may be given after using another Book of Enoch.
Effect: Spawns a trapdoor, similar to using We Need to Go Deeper
While held, gives Isaac the Compass effect, revealing Special rooms on the map
This item may be given after using another Book of Enoch.
Effect: Teleports Isaac to the Treasure Room, similar to using a Stars card
While held, increases the chance of receiving a Planetarium on the next floor
This item may be given after using another Book of Enoch.
Effect: Increases Fire Rate, grants Flight, and decreases Damage until entering a new room
While held, increases the chance of receiving an Angel or Devil room at the end of the floor
Effect: On pick-up, randomly gives one of the five other collectibles related to Enoch:
Book of Dreams
Book of Luminaries
Book of the Watchers
Epistle of Enoch
Similitudes of Enoch
Using any of these active items removes it from Isaac, then gives another at random.
Effect: Teleports Isaac to the beginning of a random stage
This consists of all legitimate floors in the base game, and may push Isaac forward if used early
Effect: Spawns a random, charmed enemy as a familiar; provides health regen to all charmed allies
Removes all available red hearts, but cannot kill Isaac
Effect: Replaces all of Isaac's Soul Hearts with Black Hearts, then temporarily increases Damage based on the number of Black Hearts held; this bonus lasts until entering a new room
Effect: Replaces all of Isaac's Black Hearts with Soul Hearts, gives one Key, and replaces all chests in the room with Eternal Chests
Effect: While firing (or charging), has a luck-based chance to increase Damage, but decrease Fire Rate and Shot Speed
Effect: When used, removes all projectiles on screen and inflicts Fear on enemies for a short time
Effect: When used, removes a Heart and adds a Broken Heart. For each use, increases Damage and Luck, but decreases Speed.
Item cannot be used if Isaac has less than two hearts available.
Effect: Replaces all Brown chests with Haunted Chests
Effect: Guarantees an Angel Room will spawn at the end of the floor after Isaac kills at least fifteen enemies
Taking damage resets kill count and incurs a penalty to deal chance
This item may be given after using another Book of Enoch.
Effect: Teleports Isaac to the Angel or Devil room, similar to using a Joker card
While held, if Isaac is reduced to one heart (or less), gives a Soul Heart, but switches to another Book of Enoch
Effect: Has a small chance to negate self-inflicted damage; additionally, has a luck-based chance to spawn a random heart at the beginning of a new floor
Effect: If Isaac has at least one full Soul Heart, has a small chance to negate incoming damage from any source
Additionally, prevents Curse of the Blind, Curse of the Lost, and Curse of the Unknown from appearing on future floors
Effect: Has a small, luck-based chance to fire a small explosive tear
Effect: Randomly increases one of Isaac's six major stats; this boost is reduced as the item gains charge
May instead grant flight or decrease Isaac's size, which lasts until the item is fully charged
Effect: Activates one of the following effects at random -
"Rock" - uses the D12 or a Hagalaz rune
"Paper" - uses the Book of Secrets or a Moon card
"Scissors" - uses Scissors or Pinking Shears
Effect: When used, massively increases Luck; this boost slowly wears off over the course of 30 seconds
Effect: When entering a Boss or Miniboss room at full health, all enemies inside take damage equal to one-quarter of their total health
This effect does not trigger on Blue Womb, or after Sheol/Cathedral
Effect: Hearts that spawn on the floor have a chance to be automatically consumed, adding them to Isaac's health. If health is full...
Red Hearts increase Luck
Soul Hearts increase Fire Rate
Black Hearts increase Damage
Eternal, Bone, and Rotten Hearts add Blue Flies
Effect: Increases Move Speed, then grants one of the following effects:
Randomly increases one of Isaac's six major stats
Decreases Size
Grants Piercing and Bouncing tears
This bonus lasts until Isaac has explored four new rooms, at which point he has a 'sugar crash.'
This decreases Fire Rate, Move Speed, and Shot Speed until Isaac explores an additional two rooms, or uses this item again
Effect: Taking contact damage causes the entity hurting Isaac to become permanently Charmed
Effect: Gives Isaac ten Keys
Effect: Slightly increases all six major stats when Isaac kills a boss or champion enemy
This effect does not trigger after Blue Womb
Effect: Upon dying, revives Isaac in the current room with 3 Rotten Hearts, and kills all active non-boss enemies (turning them into Blue flies)
This extra life will only be used after all others, and will not appear in the HUD
This item is removed after reviving
Effect: Increases Damage and Fire Rate for each Blue Fly or Spider Isaac has
If Isaac has no Flies or Spiders, instead increases Luck
Effect: Replaces all Golden chests with either Brown or Red chests, and causes all basic Red Spiders to become Blue Spiders
Effect: When Isaac takes damage, inflicts Confusion on all enemies in the room; if this was contact damage, also deals three times tear damage to the enemy hurting Isaac
Effect: Forces any "Mom" or "Dad" items collected to be dropped, then immediately activates an effect similar to using a Black Rune
Also prevents any "Mom" or "Dad" trinkets from being picked up
Effect: After killing the floor boss, randomly increases one of Isaac's six major stats based on the number of rooms explored up to that point
This effect does not trigger on Blue Womb, or after Sheol/Cathedral
Effect: Rerolls currently held trinket(s) and randomly adds one of the following:
3 - 6 Coins
2 - 5 Bombs
1 - 4 Keys
Effect: Upon dying, immediately revives Isaac with full health and three soul hearts; reviving then causes tears to have a chance to set enemies on fire
This extra life will only be used after all others, and will not appear in the HUD
This item is removed after reviving
Effect: When entering a special room first time, causes item pedestals to rotate between multiple collectibles; instead has a small chance to cause items to 'glitch' (similar to having TMTrainer)
Effect: Increases Luck after entering a Library for the first time; increases Damage when holding an 'evil' book, and increases Fire Rate when holding a 'holy' book
When entering a new floor, if Isaac has an item that provides partial mapping, fully reveals the map
Effect: Upon dying, revives Isaac with full health and restarts the floor; reviving then increases Fire Rate and Range, decreases Damage, and causes tears to orbit around Isaac
This extra life will only be used after all others, and will not appear in the HUD
This item is removed after reviving
Effect: Improves Red Chest payouts, preventing Troll Bombs and enemy spiders.
20% chance for an item
10% chance for 3-5 blue flies and a rotten heart
10% chance for 4 blue spiders
10% chance (each) for 2 soul, black, bone hearts
10% chance for 3 bombs
10% chance for black sack
10% chance for 3 pills
Effect: If Isaac's Luck is less than seven, increases it to seven
Effect: Picks up and stores Slot Machines and Beggars, allowing them to be moved to another room.
When used again, any stored entities are spawned in the same spot they were taken from
Can only pick up one of each type of slot/beggar
This item may be given after using another Book of Enoch.
Effect: Deals ten times Isaac's damage to all enemies in the current room
While held, killing any of the Four Horsemen bosses permanently increases Damage and Fire Rate
Effect: Increases Fire Rate and Shot Speed based on the total number of rooms on the current floor
Effect: While firing (or charging), has a luck-based chance to decrease Damage, but increase Fire Rate and Shot Speed
Effect: When used, removes a Heart and adds a Broken Heart. For each use, increases Fire Rate and Shot Speed, but decreases Speed.
Item cannot be used if Isaac has less than two hearts available.
Effect: Replaces a random room reward with a Brown Chest
This only affects core pick-ups and does not include hearts
Effect: After taking damage, grants Isaac freezing tears until he leaves the room; if this was contact damage, causes the entity hurting Isaac to immediately die and shatter into ice shards
Effect: When dealing damage to enemies, has a luck-based chance to double this damage
Effect: When entering a Boss Room for the first time, grants the effects of a reverse Strength card
This effect does not trigger on Blue Womb, or after Sheol/Cathedral
Effect: When entering a Boss Room for the first time, slightly increases all six of Isaac's major stats based on the number of rooms containing enemies explored on the floor
This effect does not trigger on Blue Womb, or after Sheol/Cathedral