Upon activation a random pill will spawn in Isaac's inventory, causing the player to drop their current held Q - slot item, if any. A player will only receive six different pill types in one playthrough.
- Pill-related Items such as PHD or Lucky Foot (or playing as Cain) are best with this item, as they prevent the player from receiving negative pill effects.
- As with most Activated Items, Items such as Habit, 9 Volt, and The Battery decrease the charge time, increasing the effectiveness of this item.
- Works well with Habit, recharging Mom's Pill Bottle by 3 bars every time the player is hit allowing for "pill farming" as with many other activated items.
- Judging from the title of the item, this can infer that Isaac's mother self medicates with whatever pills she can get her hands on. This might explain her unstable behavior.