| Pickups |
| Hearts | Coins | Bombs | Keys | Batteries | Pills | Cards | Chests | File:DLC Indicator.png Sacks |
Pills are pickups that can provide useful or inhibiting effects. They take up the same slot as cards and runes.
At the start of each run, an effect is randomly assigned to each color of pill. The pill effect for that color will remain constant throughout the run. (However, it is possible for PHD or Virgo to reassign some of the effects, such that 2 different colored pills will have the same effect.) The set of pill effects for any given run is usually known as the pill pool.
Lunatic Mod's custom pills are currently unreleased, but are expected to be added in upcoming updates.
Pill Effects[ | ]
| Pill | Effect |
| Alzheimers' | Isaac "forgets". or loses, one random item from his inventory. |
| Asbestos | Burns all enemies in the room for a short amount of time, dealing small amounts of damage. |
| Balls of Steel? | Grants Isaac two Black Hearts. |
| Confusion! | Isaac's controls are inverted for a short period of time. |
| Evil Up! | All Soul Hearts in the floor and in Isaac's health bar are replaced with Black Hearts. |
| Hematocheria | Spawns a red poop and red creep near Isaac. |
| Hypersomnia | Isaac falls asleep, being fully healed as if he used he Bed in Isaac's Room. |
| I'm Dizzy... | Isaac's movements become slurred, as if he was on ice. |
| Macropsia | Isaac shrinks in size for a short period of time, with his damage being drastically lowered. |
| Money Where Your Mouth Is | Spawns a nickel, dime, or the "A Quarter" item. |
| Nasty Gas | Poisons all enemies in the room for a short amount of time, dealing small amounts of damage. |
| Overdose! | Reduces Isaac's health to one full heart. If Isaac has no hearts, his health is reduced to two full spirit hearts. |
| Projectile Vomiting | Gives Isaac the effects of IPECAC for the room. |
| Seeing Red | Turns certain pickups into their Magic Red variants. |
| Tic-Tac | Gives Isaac a dumb-looking smile. This pill is cosmetic-only, and does absolutely nothing to Isaac's stats. |
| Tunnel Vision | Darkens any rooms Isaac is in for a short period of time. |
Pill Appearances[ | ]
Strategy[ | ]
- Use of unidentified pills is recommended for outside of combat as Confusion!, Hematocheria, I'm Dizzy..., Macropsia, and Overdose! can be detrimental mid-fight. However, Asbestos, Nasty Gas, and Projectile Vomiting are nearly useless outside of combat.
 Bosses
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 Cards and Runes
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 Challenges
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 Chapters
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 Characters
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 Items
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 Monsters
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 Objects
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Pills
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 Transformations
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 Trinkets
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 Unlockables
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