Cards and Runes

Pickups

Hearts

Coins

Bombs

Keys

Batteries

Pills

Cards

Chests

File:DLC Indicator.png Sacks

Cards and runes are usable items with a wide variety of effects. They take up the same slot as pills.

Runes and special cards are unlocked by completing challenges.

Cards[ | ]

Major Arcana Cards[ | ]

When on the ground, these cards look like this:

Name	ID	Icon	Message	Effect
0 - The Fool	1	File:0 - The Fool Icon.png	"Where journey begins"	Teleports you back to the starting room of a floor.
I - The Magician	2		"May you never miss your goal"	Grants homing tears for the current room.
II - The High Priestess	3		"Mother is watching you"	Mom's dismembered leg is called down to deal 300 damage to anything it stomps. It will always stomp on the enemy with the most health. If used in an empty room or during the fight with Mom, it will stomp Isaac instead.
III - The Empress	4		"May your rage bring power"	Triggers the Whore of Babylon effect.
IV - The Emperor	5		"Challenge me!"	Teleports you into the Boss Room of a floor.
V - The Hierophant	6		"Two prayers for the lost"	Spawns 2 Soul Hearts.
VI - The Lovers	7		"May you prosper and be in good health"	Drops 2 full red hearts. If used in a Black Heart or Eternal Heart-containing Super Secret Room, it will spawn those types of hearts instead.
VII - The Chariot	8		"May nothing stand before you"	Grants the temporary invulnerability effect of My Little Unicorn.
VIII - Justice	9		"May your future become balanced"	Spawns one of each consumable drop (a heart, a key, a bomb, and a coin).
IX - The Hermit	10		"May you see what life has to offer"	Teleports you to the shop. If there is no shop, this will act as a random teleport. If the shop has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance).
X - Wheel of Fortune	11		"Spin the wheel of destiny"	Spawns an arcade machine (Slot Machine or Fortune Teller).
XI - Strength	12		"May your power bring rage"	Upon use, increases all of Isaac's stats except tears and adds one (temporary) heart container for the current room.
XII - The Hanged Man	13		"May you find enlightenment"	Removes Isaac's body, allowing him to fly around similar to Transcendence.
XIII - Death	14		"Lay waste to all that oppose you"	Deals 40 damage to all enemies in the room.
XIV - Temperance	15		"May you be pure in heart"	Spawns a blood donation machine. File:DLC Indicator.png Spawns a devil beggar in Greed Mode.
XV - The Devil	16		"Revel in the power of darkness"	Increases your damage by 2 until you leave the room (same effect as the Book of Belial).
XVI - The Tower	17		"Destruction brings creation"	Spawns 6 troll bombs randomly around the room.
XVII - The Stars	18		"May you find what you desire"	Teleports the player to the Treasure Room. If there is no Treasure Room, this will act as a random teleport. Randomly chooses a Treasure Room on Curse of the Labyrinth. If the Treasure Room has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance).
XVIII - The Moon	19		"May you find all you have lost"	Teleports the player to the Secret Room. This card will open one random wall once inside the Secret Room, so you can leave even if you don't have any bombs available.
XIX - The Sun	20		"May the light heal and enlighten you"	Restores full health, deals 100 damage to all enemies in the room, and reveals the map for the current floor, except the Super Secret Room.
XX - Judgement	21		"Judge lest ye be judged"	Spawns a Beggar.
XXI - The World	22		"Open your eyes and see"	Reveals the entire floor, except for the Super Secret Room. Has no effect if under the effect of Curse of the Lost or Amnesia.

Playing Cards[ | ]

When on the ground, these cards look like this:

Name	ID	Icon	Message	Effect
2 of Clubs	23	File:2 of Clubs Icon.png	"Item multiplier"	Doubles your bombs. If you have no bombs, gives you 2 instead.
2 of Diamonds	24	File:2 of Diamonds Icon.png	"Item multiplier"	Doubles your coins. If you have no coins, gives you 2 instead.
2 of Spades	25	File:2 of Spades Icon.png	"Item multiplier"	Doubles your keys. If you have no keys, gives you 2 instead.
2 of Hearts	26	File:2 of Hearts Icon.png	"Item multiplier"	Doubles Isaac's current number of red hearts. Soul and Black hearts are unaffected. Doesn't add new heart containers, just fills empty ones.
Ace of Clubs File:Afterbirth† Indicator.png	27	File:Ace of Clubs Icon.png	"Convert all"	Turns all pickups and chests in the room into bombs.
Ace of Diamonds File:Afterbirth† Indicator.png	28	File:Ace of Diamonds Icon.png	"Convert all"	Turns all pickups and chests in the room into coins.
Ace of Spades File:Afterbirth† Indicator.png	29	File:Ace of Spades (card) Icon.png	"Convert all"	Turns all pickups and chests in the room into keys.
Ace of Hearts File:Afterbirth† Indicator.png	30	File:Ace of Hearts Icon.png	"Convert all"	Turns all pickups and chests in the room into random heart pickups.
Joker	31		"???"	Teleports you to the Devil Room or Angel Room.

Special Cards[ | ]

When on the ground, these cards look like this:

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Runes[ | ]

Left Pointing Runes[ | ]

When on the ground, these runes look like:

Rune	ID	Message	Unlocked method	Effect
Hagalaz	32	Destruction	Rune of Hagalaz Beat challenge #1	Destroys all breakable objects in the room. Does not affect Key Blocks.
Jera	33	Abundance	Rune of Jera Beat challenge #2	Clones all pickups and chests in a room (even shop pickups; the clones can then be picked up for free). Cloned chests will contain exactly the same type of items: if the original contains a pickup, so will the clone; the same is true for Collectibles. Cannot clone other Jera runes and trinkets.
Ehwaz	34	Passage	Rune of Ehwaz Beat challenge #3	Creates a trapdoor leading to the next floor. Has an estimated 1/12 (8%) chance to spawn a door to a Crawl Space instead.
Dagaz	35	Purity	Rune of Dagaz Beat challenge #4	Removes any curses from the current floor and grants a soul heart. (This will not remove Curse of the Labyrinth.)

Right Pointing Runes[ | ]

When on the ground, these runes look like:

Rune	ID	Message	Unlocked method	Effect
Ansuz	36	Vision	Rune of Ansuz Beat challenge #5	Reveals the whole map, including the Secret Room and the Super Secret Room.
Perthro	37	Change	Rune of Ansuz Beat challenge #5	Rerolls all pedestal items in the room. (This is the same effect as the D6.)
Berkano	38	Companionship	Rune of Berkano Beat challenge #20	Summons 3 friendly blue flies and 3 friendly blue spiders.
Algiz	39	Resistance	Rune of Algiz Beat challenge #8	Grants a shield which lasts for 30 seconds.
Blank Rune File:DLC Indicator.png	40	???	Blank Rune Beat challenge #30 (The unlock is bugged and actually unlocks Kidney Stone in Afterbirth. Fixed in Afterbirth Plus.)	Grants a random rune effect. Has a 25% chance to spawn another Blank Rune upon use.

Other Runes[ | ]

Rune	ID	Icon	Message	Unlocked method	Effect
Black Rune File:Afterbirth† Indicator.png	41		Void	Black Rune Defeat Ultra Greedier as Apollyon	Deals 40 damage to all enemies in the room. Consumes all pickups in the room and turns them into blue flies and spiders. Consumes all pedestal items in the room and turns them into random stat upgrades.

Other[ | ]

These are items other than cards and runes (and pills) that take up the consumable slot. When on the ground, each of these items are uniquely identifiable by their respective icon.

Name	ID	Icon	Message	Effect {{:{{{1}}} \| {{{1}}} \| {{{2}}} }} {{:{{{1}}} \| {{{1}}} \| {{{2}}} }}

Notes[ | ]

The game counts runes as cards for the purposes of Starter Deck, Blank Card and File:Afterbirth† Indicator.png Tarot Cloth.
File:DLC Indicator.png Using the Blank Card with the ? Card teleports the player to the I AM ERROR room of the current floor. This consumes both the Blank Card and the ? Card.
Using the Joker card in The Womb II or Utero II will instantly teleport the player to the Devil Room or Angel Room with a trapdoor leading to Sheol or to the Cathedral. This can be used to skip Mom's Heart or It Lives and will not count as a kill.
- File:DLC Indicator.png After unlocking It Lives, Devil or Angel Rooms in The Womb II, Utero II, and Scarred Womb II no longer contain trapdoors and instead have their normal contents.
Using The Joker card can allow Isaac to encounter Devil Rooms or Angel Rooms on floors they otherwise cannot appear on.
If you use the Strength card with only one spirit heart left, and lose the spirit heart while in the same room, you retain the full heart container that Strength grants after you leave.

Unlockable Achievements[ | ]

The Necronomicon The Necronomicon - Use XIII - Death 4 times.

Blinding Baby File:DLC Indicator.png Blinding Baby - Use Blank Card while holding XIX - The Sun.

Trivia[ | ]

In the expansion of the original game, Wrath of the Lamb, there was a positive pill effect called "Friends Till The End", which summoned 3 blue attack flies. This effect was improved, given to the rune Berkano in Rebirth, and added again in Afterbirth with the original effects.
The Suicide King card is a reference to the King of Hearts card, which is usually called that way because it depicts a king in a way that he appears to be sticking his sword into his head.
The Chaos Card is a reference to the Magic: The Gathering card "Chaos Orb", which also instantly destroys enemies that it touches.
The Get out of Jail Free card is a reference to a card with the same name that appears in the table game Monopoly.
The "A Card Against Humanity" card is a reference to the card game "Cards Against Humanity".

Bugs[ | ]

Bug! File:DLC Indicator.png Using the Joker card to enter a Devil Room / Angel Room in the Blue Womb will cause the music of the floor to continue playing instead of the normal Devil Room / Angel Room music.