This item has replaced Charm of the Vampire.
Changes: In addition to its vanilla effects, taking contact damage now causes the entity hurting Isaac to begin Bleeding
This item has replaced Zodiac. There have been no changes to its vanilla effects.
This item has replaced Cricket's Head.
Changes: In addition to its vanilla effects, now decreases Speed and Shotspeed
Changes: This item can now unlock Golden and Stone chests
This item has replaced Dead Cat.
Changes: This item no longer spawns a familiar.
Changes: This item is now used automatically when fully charges
This item has replaced Playdough Cookie.
Changes: In addition to its vanilla effects, now has a chance to activate one of the following Dice when entering a new room:
D10
D12
D20
This item has replaced Deep Pockets. There have been no changes to its vanilla effects.
This item has replaced Abaddon.
Changes: In addition to its vanilla effects, now has a chance to deal 40 damage to enemies in the room.
This item has replaced Hungry Soul.
Changes: In addition to its vanilla effects, taking contact damage causes the enemy hurting Isaac to become charmed for 10 seconds
This item has replaced Binge Eater.
Changes: In addition to its vanilla effects, caps Speed at 1.0 and increases size.
This item has replaced Sanguine Bond.
Changes: In addition to its vanilla effects, taking an item in a devil room increases future devil deal chances by 5%, and guarantees a devil room will spawn on the Cathedral/Sheol floor
This item has replaced Lusty Blood.
Changes: In addition to its vanilla effects, now rerolls all neutral pills into positive pills.
This item has replaced Bloody Gust.
Changes: In addition to its vanilla effects, taking damage now pauses the current room until Isaac shoots
This item has replaced Hypercoagulation.
Changes: In addition to its vanilla effects, now has a 25% chance to remove a newly-spawned heart, regardless of its source
This item has replaced Money = Power.
Changes: In addition to its vanilla effects, has a chance to replace special coins with a single Penny
This item has replaced Bloody Lust.
Changes: In addition to its vanilla effects, now causes Isaac to explode when taking damage
Changes: In addition to its vanilla effects, now deals damage to end-game bosses equal to 25% of their maximum health and causes Bleeding
This item has replaced Wooden Spoon.
Changes: In addition to its vanilla effects, now prevents Curse of the Labyrinth, Curse of the Lost, and Curse of the Maze from appearing on future floors
This item has replaced Mom's Wig.
Changes: In addition to its vanilla effects, has a luck-based chance to spawn a Blue Fly while firing (or charging)
This item no longer heals a red heart on pickup.
This item has replaced Guppy's Head.
Changes: In addition to its vanilla effects, now has a chance to replace Red hearts with Rotten hearts while held
This item has replaced Box of Spiders.
Changes: In addition to its vanilla effects, now causes half a heart of damage to Isaac, and will replace any core pickups in the room with Blue Flies
This item has replaced Judas' Shadow.
Changes: In addition to its vanilla effects, now gives 30 coins on pickup
This item has replaced Gnawed Leaf.
Changes: In addition to its vanilla effects, now removes the time limit to enter Boss Rush or the Blue Womb floor.
This item has replaced Adrenaline.
Changes: In addition to its vanilla effects, now immediately removes almost all Red health, leaving only half a heart
This item has replaced Wooden Nickel.
Changes: In addition to its vanilla effects, now has a chance to spawn a different core pick-up, rather than a Coin
This item has replaced Holy Grail.
Changes: In addition to its vanilla effects, now prevents flight from being removed by any source.
This item has replaced Serpent's Kiss.
Changes: In addition to its vanilla effects, now causes tears to wiggle back and forth when fired
This item has replaced Brittle Bones.
Changes: In addition to its vanilla effects, now has a chance to replace pedestals with an item from Houngan's Voodoo pool
This item has replaced The Parasite.
Changes: In addition to its vanilla effects, now decreases Shotspeed
This item has replaced Depression.
Changes: This item now spawns several pillars of light (similar to Crack the Sky) when Isaac takes damage.
This item has replaced Fire Mind.
Changes: This item now sets enemies on fire and puts out any fires in the room when Isaac takes damage.