Items

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Items are a key mechanic in The Binding of Isaac, often modifying Isaac's attributes, stats, tears, or granting him special abilities, among many more effects. Items are separated into two categories: Passive items, which apply a passive effect to Isaac while held, and Active items, which activate an effect when used.

Epiphany introduces 47 new items into the game, split into 21 Active items and 26 Passive items.

Active Items

Item	Image	Flavor Text	Effect	Charges	Quality	Unlock
D5		"Reroll trinkets"	On use, rerolls all trinkets in the room. Rerolled trinkets have a small chance of becoming golden, or becoming a normal trinket if already golden.		1	Defeat Delirium as Tarnished Isaac.
First Page		"Isaac and..."	Summons a duplicate of the player's current character that is controlled alongside the player in a similar fashion to Jacob & Esau. The additional character spawns with copies of the items and health the player had at the time of use.	(Single use)	4	Defeat The Beast as Tarnished Isaac.
Blighted Dice		"Reroll a part of you"	On use, allows the player to select any Passive item they have. Using the item again with a passive item selected removes it and spawns 2 item pedestals of the same quality and item pool. Only one can be taken. After being used, turns into Broken Dice. Using Broken Dice only spawns a single item pedestal and removes a single heart container or 2 Soul Hearts. Collecting an item with Broken Dice destroys it and turns it back into Blighted Dice. Recharging Broken Dice also turns it back into Blighted Dice.	(Blighted Dice) (Broken Dice)	4	Obtain all Completion Marks as Tarnished Isaac.
Weird Heart		"Reusable mess"	On use, rerolls the player's health into a random combination of Red Heart containers, Soul Hearts, Black Hearts and/or Bone Hearts. Chance to either decrease or increase the total amount of health Isaac has by up to 2 on use.		2	Defeat Delirium as Tarnished Magdalene.
Cardiac Arrest		"Sheer heart attack"	On use, fires a large heart projectile in any direction. Grants a temporary damage increase for each enemy hit by the projectile. Enemies hit drop half Red Hearts that quickly disappear. Damages Isaac for half a heart on use.	(5 seconds)	4	Obtain all Completion Marks as Tarnished Magdalene.
Final Wishes		"Make them count"	On use, consumes a pedestal item in the room and spawns up to 7 random pickups. All subsequent pedestal items will cycle between an additional option. Consuming items with Final Wishes will cause subsequent items to cycle between even more options, up to 6. Taking an item resets the process and subsequent item pedestals will not cycle until Final Wishes is used again.		4	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Cain.
Surprise Box		"There could be anything inside!"	Holding down the drop button while picking up a pickup will charge Surprise Box. On use, creates an item pedestal and causes several pickups to go flying out. The item and pickups created depend on the pickups collected.	(12, single use)	2	Defeat The Beast as Tarnished Cain.
Throwing Bag		"Weapon of the cold-blooded"	Causes Isaac to begin swinging a bag around him, which can be thrown in any direction. The thrown bag damages enemies and produces rocks around it on contact. Can bag item pedestals in order for the bag to obtain new synergies and properties.	(Varies)	4	Obtain all Completion Marks as Tarnished Cain.
Descent		"Embrace the darkness"	Passively creates a shadow of Tarnished Judas that mirrors Isaac's movements. On use, swaps places between Isaac and the shadow, damaging enemies and leaving behind damaging shadowy particles between them.	(5 seconds)	3	Obtain all Completion Marks as Tarnished Judas.
Savage Chains		"Wallow in hate"	On use, restrains Isaac in place and renders them unable to move. While immobile, slowly increases the player's damage, tears, and shot speed stats. Using it again frees Isaac and removes the increased stats.	(2 seconds)	3	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Samson
Killer Instinct		"No holding back"	On use, if Isaac is standing still, deals damage to all enemies in a short range around Isaac. If Isaac is moving, causes him to dash forward, gaining invincibility and dealing damage to enemies he makes contact with.	(2 seconds)	3	Obtain all Completion Marks as Tarnished Samson.
Debug		"table.insert(inventory, PERMANENT_ITEM)"	On use, allows the player to choose one of three random passive items they have. Choosing an item rerolls it into an item from the same item pool and of the same quality.		4	Obtain all Completion Marks as Tarnished Eden.
Divine Remnants		"Pray for grace"	Passively grants a Holy Mantle shield while fully charged. When the shield breaks, all charges are drained and the item goes up a level On use, rerolls all item pedestals in the room into ones with the nolostbr tag, rerolls all hearts into other pickups, and causes the item to go down a level Higher levels grant better rerolled items	(level one) (level two) (level three)	4	Obtain all Completion Marks as Tarnished Lost.
Turnover		"Give tithe"	On use, creates a Shop in the current room, selling various items and pickups. The products sold depends on the type of room it was used in. When used in a room with a shop already in it, the shop is upgraded to sell more pickups and items and also spawn different Beggars & Machines, up to 3 times. Consumes coins on use, depending on the room it's being used in and the amount of upgrades the shop has (if there is a shop in the room).		4	Obtain all Completion Marks as Tarnished Keeper.
Mom's Hug		"Tender loving care"	On use, causes Isaac to grab an enemy in the direction he is facing. Holding down the fire buttons causes Isaac to spin the enemy around before throwing them when the button is let go or after a few seconds. Enemies killed via the throw spawn temporary Red Hearts.	(5 seconds)	2	Complete the challenge Sweet Tooth
Chance Cube		"Calculated risk"	On use, transforms every enemy in the room into a random assortment of pickups and (rarely) items while also increasing a "Risk" percentage. The Risk percentage shows the chance of Isaac dying when using the item, but a higher Risk will transform enemies into higher quality pickups and items. Using the item in a room with no enemies will consume pickups to lower the Risk percentage.		2	Complete the challenge Overwhelming Odds.
Empty Deck		"My kingdom for a card"	On use, transforms all pickups in the room into 1 - 5 cards, based on their value.		2	Use 50 or more cards in total
Portable Dice Machine		"Reroll 24/7"	On use, creates a random Dice Capsule.		3	Defeat Mega Satan as Tarnished Isaac.
Delirious Die Dispenser		"Reroll 24/7"	On use, creates a random Dice Capsule. Also rerolls all Dice Capsules in the room into random other capsules.		4	Defeat Mega Satan as Tarnished Isaac.

Passive Items

Item	Image	Flavor Text	Effect	Quality	Unlock
Mother's Shadow		"Someday she'll get to you"	Grants a permanent Curse of Darkness. Knives fall onto random locations in rooms, not damaging Isaac but dealing heavy damage to enemies hit by them.	2	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Isaac.
Warm Coat		"You feel cozy"	+1 Health. 50% pseudo-random chance to block any source of damage.	3	Defeat The Beast as Tarnished Magdalene.
True Love		"Love who you are"	Heart pickups are more likely to spawn as types Isaac already has in his health bar.	3	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Magdalene.
Dark Rock		"Sacrificial power"	Speed -0.20 Tears -0.40 Damage +0.50 Damage Multiplier x1.5 Range -1.00 Shot Speed -0.15 Luck -2.00	3	Defeat Mega Satan as Tarnished Judas.
Broken Halo		"A little taste of sin"	Spawns a trapdoor that leads to a special Devil Deal at the start of each floor. This room contains Devil Deal items that cost heart containers, pickups surrounded by spikes that deal damage to the player on pickup, and at least one Devil Beggar.	3	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Judas.
Old Knife		"It's still as sharp as ever"	Grants a knife familiar that flies forward in the direction Isaac is firing, stabbing itself into enemies to damage them and give them Bleed. Stabbed enemies emit an aura that grants the player +1.5 damage while within it.	2	Defeat Delirium as Tarnished Judas.
Kin's Curse		"Share the pain"	Damaging an enemy deals damage to all enemies of the same type in the room.	3	Defeat The Beast as Tarnished Judas.
Crimson Bandana		"Up close and personal"	Isaac emits a small, red aura that causes enemies inside it to take double damage.	2	Defeat Delirium as Tarnished Samson.
Broken Pillar		"Bring them down with you"	Grants a chance for rocks to be replaced with pillars that can be destroyed with tears, dropping boulders. Boulders can be picked up and thrown at enemies, inheriting Isaac's tear effects.	2	Defeat The Beast as Tarnished Samson.
Segmentation Fault		"ACCESS_VIOLATION"	Luck-based chance to fire a glitched tear that can transform enemies it hits into another enemy, a random pickup, a shopkeeper, or a fireplace. Caps out at 25% at 15 luck.	2	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Eden.
Zip Bombs		"Crepitus recurrere est"	+5 bombs. Bombs placed respawn after exploding and explode an additional time, up to 3 times for a total of 4 explosions.	2	Defeat Delirium as Tarnished Eden.
Printer		"Make your own fun!"	Using an active item while holding a card will cause all future usages of that card to activate the effect of the active item.	3	Defeat The Beast as Tarnished Eden.
Linen Shroud		"Haunting tears + tears up"	+0.77 tears Isaac's tears cause up to 5 tears to begin circling the enemy on impact Once the fifth tear is landed, all surrounding tears fly into the enemy at once The tears fly earlier if their damage would be enough to kill the enemy.	4	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Lost.
Bottled Spirits		"Haunting tears + tears up"	Luck-based chance for Isaac's tears to inflcit enemies with Weakness, slowing them and making them take double damage Starts at a 5% chance to fire a Weakness tear, capping out at 15% at 15 Luck	3	Defeat Delirium as Tarnished Lost.
Lil Guppy		"Scaredy-cat"	Grants a Guppy familiar that wanders around the room, avoiding Isaac and blocking projectiles Increases Isaac's Tears depending on how far Isaac is from the familiar and how many enemies are near it Dies after taking too much damage, granting a +0.66 tears up for the floor and reappearing on the next floor	2	Defeat The Beast as Tarnished Lost.
Stock Fluctuation		"Now's your chance!"	Future shop items constantly change price from 0 to twice the original price. Touching a shop item without being able to afford it removes the item.	2	Defeat Isaac, ???, Satan, and The Lamb as Tarnished Keeper.
Bad Company		"Bad, bad company, 'til the day I die"	Standing near a Shopkeeper will transform it into a friendly Greed or Super Greed mini boss, depending on the type of Shopkeeper transformed, for 15 - 20 coins.	1	Defeat Delirium as Tarnished Keeper.
Golden Cobweb		"My precious friends!"	Blue Flies and Blue Spiders are now golden in color, and petrify enemies into gold on contact. Golden enemies drop 1 - 3 coins on death.	1	Defeat The Beast as Tarnished Keeper.
Thirty Pieces of Silver		"Suffering from success"	+30 coins. Occasionally grants coins on room clear. Grants a damage up based on how few coins Isaac has.	3	Complete the challenge Kagemane no Jutsu
Nothing		"Disappointment up"	Grants a tears up based on how few items Isaac has and the current level Isaac is on.	2	Complete the challenge One With Nothing
Coin Case		"Every piece contains a memory"	Coins have a chance to glow, increasing a certain stat based on the color of it and the worth of the coin.	3	Complete the challenge Dealmaker
Revolt		"Ready or not, here they come"	Causes Philistines to spawn after clearing normal rooms. Killing them will reward Isaac with pickups and potentially an item.	0	Complete the challenge He Who Cast The First Stone
Retribution		"Divine punishment"	+1 Soul Heart Taking Soul/Black Heart damage or breaking a Holy Mantle shield causes Crack The Sky beams to strike around the room.	2	Complete the challenge Retribution
Woolen Cap		"Counting sheep"	Spawns a friendly Sheep when entering a new floor or sleeping in a bed. Sheep wander around the room and attract enemies, eventually dying and inflicting slow onto enemies.	1	Bag 50 items as Tarnished Cain
Work In Progress		"Technical difficulties!"	Activates a random effect in every hostile room: Spawns 3 Technical Character minisaacs for the room Triggers the Mom's dresser effect and spawns several drawings on the floor, which increases the player's Tears stat while standing on them Increases the speed of the music and gives a Range and Shot Speed up depending on the speed of the music All enemies get a random status effect for 5 seconds All of the above	1	Start a run with an Epiphany character 50 times
Blight		"It's infecting me"	No effect. Can only be obtained by using Broken Dice on an HP Up item when its associated pool is out of items. Attempting to reroll Blight using the Blighted Dice or Broken Dice rerolls it into more Blight.	0

Quest Items

Quest Items are special items that are involved in the unlocking process of a few of the Tarnished characters. Under normal circumstances, these items cannot be obtained outside of the unlocking process.

Active Items

Item	Image	Flavor Text	Effect	Charges	Quality
Blighted Photo		"It's all my fault"	Passively replaces all collectibles with Blight On use, damages Isaac and destroys the nearest Blight, creating two random items from the current item pool Only one can be taken		0
Child's Drawing		"..."	When picked up, instantly warps Tainted Isaac to an altered version of the Home floor. Cannot be used otherwise		0
Bleeding Heart		"Heartaches by the number"	Passively grants a massive Tears down. Heals up to 2 red hearts on use. Replaces Tainted Magdalene's pocket Yum Heart if Yum Heart is used in a Sacrifice Room, and can only be obtained by her.		0
K.A.E.K.		"Keeper's Association Entrance Keycard"	Passively reduces the amount of coins that spawn at the end of Greedier Mode waves, but increases the chance for more valuable coins to spawn. On use, heals the player for one Coin Heart and makes 0 - 2 shop items free. Must be renewed by a special NPC in the shop for an increasing amount of coins, turning into Expired K.A.E.K if it is not renewed and becoming useless. Can only be obtained and held by Tainted Keeper during Tarnished Keeper's unlock process.		0
Delilah's Razor		"Dead memories"	Passively allows Tainted Samson to enter Challenge Rooms and Boss Challenge Rooms regardless of his current health. On use, causes fake damage similar to the Dull Razor. Can only be obtained and held by Tainted Samson during Tarnished Samson's unlock process.		0
Broken Orb		"Shatter your destiny"	On use, converts all item pedestals in the room into Mantle Shards that grant a single use Holy Mantle shield when picked up Defeating the boss of a floor will force Tainted Lost to fight another boss from the next floor.		0

Passive Items

Item	Image	Flavor Text	Effect	Unlock
Sharp Rock		"Reap what you sow"	Can only be obtained by Tainted Cain during the unlock process of Tarnished Cain. Replaces Cain's Bag of Crafting with a Throwing Bag that cannot be thrown. Killed enemies have a chance to drop collectible wheat.
Glitched Photo		"³§„¡ù•¡àBù„«ÿÑB§ÿ¡«àѳ¡"	Rerolls all enemies and obstacles in hostile rooms. Can only be obtained via defeating the floor 1 boss in 1 minute as Tainted Eden, and is apart of Tarnished Eden's unlock process.
Dimensional Key		"The end and the beginning"	Spawns a portal to The Void after defeating Mother and in the closet in Home. Only spawns in the Super Secret Room of Corpse 2 and in the first Red Room of Basement 1 during the Ascent.	Defeat Delirium as Tarnished Cain.

Unused Items

There are a handful of items introduced in Epiphany that are unobtainable as of Wave 4, either because they are unlocks for future characters or are going to be reworked in the future.

Active Items

Item	Image	Flavor Text	Effect	Charges	Quality	Unlock
Dark Power		"Sacrificial power"	Grants the following stat changes for the current room on use: Speed -0.12 Tears -0.28 Damage +0.50 Range -0.02 Shot Speed -0.15 Luck -1.00		1	Defeat an unknown boss as Tarnished Azazel

Passive Items

Item	Image	Flavor Text	Effect	Quality	Unlock
Living Blood		"Find help in your own suffering"	When Isaac takes damage, a blood clot is created for every half heart that is removed.	3	Unknown
Ophanim		"???"	Grants an orbital familiar of unknown use.	???	Defeat an unknown boss as Tarnished Bethany.