Makes Isaac take a full heart of damage from all sources for the current room. Unlocked by completing Challenge #24: PAY TO PLAY.
|Friends Till The End!|
Spawns three Blue Flies.
Destroys all poop in the room and spawns a single Blue Spider under Isaac and on each destroyed poop.
Spawns Blue Spiders equal to the number of enemies in the room. If there are no enemies in the room, spawns 1-3 Blue Spiders.
|One Makes You Small|
Decreases Isaac's size and increases the pitch of his voice. This effect decreases the size of Isaac's hitbox.
|One Makes You Larger|
Increases Isaac's size and decreases the pitch of his voice. This effect does not increase the size of Isaac's hitbox.
Activates an effect similar to The Gamekid.
For a short time, poop spawns wherever Isaac moves, like Explosive Diarrhea but with poop. A higher move speed means you can touch more tiles in the same time. A pun on laxatives. Unlocked by completing Challenge #25: Have A Heart.
Briefly pixelates the screen 3 times over 30 seconds.
Gives the Curse of the Maze effect for the remainder of the floor. The effect can stack with other curses. If no other curses are active for the floor, Curse of the Maze will appear under the level name when TAB is held. This effect cannot be negated by Black Candle. Unlocked by completing Challenge #25: Have A Heart.
- Among the attribute modifying pill effects, only five of the seven visible attributes are covered: health, range, tears, speed, and luck. Both shot speed and damage can't be altered by pills.
- Pill effects are narrated upon use, as are cards and runes.
- Currently, the "Retro Vision" pill effect can crash the game on some machines, resulting in restarting the current floor when the game is continued.
- Use of unidentified pills is recommended for outside of combat as Hematemesis, R U a Wizard, Paralysis, and Addicted! can be detrimental mid-fight. However, Percs, Power Pill, Lemon Party, Bad Gas, and Pheromones are nearly useless outside of combat. The shield effects like from Power Pill can be utilized for Curse Rooms.
- Hematemesis is the vomiting of blood.
- Lemon Party is an internet shock site featuring a group of elderly men performing oral sex.
- I Found Pills (and Ate Them), R U a Wizard? and I can see Forever are all image macro memes.
- Balls of Steel is a reference to Duke Nukem; it is one of Duke's more famous quotes.
- In the original game, Wrath of the Lamb, there was another positive pill effect called "Friends Til The End", which summoned 3 blue attack flies. This effect was improved and given to the Rune Berkano in Rebirth. Note that the "Infested?" and "Infested!" pill effects in Afterbirth are similar to the original "Friends Til The End" effect, only with spiders instead of flies.
- The pill effect was re-added.
- 48 Hour Energy is a reference to the drink 5 Hour Energy.
- "One makes you larger" and "One makes you small" reference the song "White Rabbit" by Jefferson Airplane, which in turn references Alice in Wonderland.
- "Percs" is a reference to a street name for the prescription drug Percocet, which is more generically known as Oxycodone. This drug is meant to be used to treat pain, but often abused for recreational purposes.
- "Pretty Fly" is a reference to The Offspring's song, "Pretty Fly (For a White Guy)".