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Pills

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Judas foundpills
Judas finding a blue pill.
Pills are random items that are dropped by enemies, found in chests, or spawned in rooms. Pills are consumed by pressing 'Q'. They come in many colors and the effects change every time you play. Note, the pills DO NOT work like Tarot cards which you can learn the effects of before use, the color of a pill does NOT foretell its effect in any way. However, if you use a pill and pick up a 2nd pill of identical colors in that playthrough, it will have the same effect as before and its name will be shown, replacing "???". The same goes for additional duplicates you find. Note, however, that if you've used a pill with a certain effect, the same effect may recur with a different pill as well (some examples below).

Pill effects can vary from one-off effects to permanent changes. Both the PHD and Lucky Foot items replace all negative stat pill effects with their positive counterparts (neutral effects such as Telepills and Bad Gas are not affected). You may only have one card or pill at a time, and picking up another card or pill will cause you to drop the other one.

Negative pill effects have an 80% effect of their positive counterparts (e.g. Speed Up increases speed by 30% while Speed Down decreases speed by 24%) except for Health Down.

Pills are an item on the Collection Grid (8,5) and are unlocked by finding any random pill.

If the PhD has been obtained, unknown pill types have a chance to be revealed (1/150 chance every frame). Also, if Telepills has not been identified as a pill yet, PhD will guarantee that it will not be in the pill "rotation".

Pills in the Shop cost 5 coins, 3 when on sale.

Pill VariationsEdit

Pill Blue Blue Ground Pill Blue Blue Menu Pill White Blue Ground Pill White Blue Menu
Pill Yellow Yellow Ground Pill Yellow Yellow Menu Pill White White Ground Pill White White Menu
Pill Spotted-Red Red Ground Pill Spotted-Red Red Menu Pill White Red Ground Pill White Red Menu


Pill EffectsEdit

Pill Name Effect
Bad Gas

Poisons any enemies near Isaac. Identical to the item The Bean when activated and the passive effect of The Black Bean.

Bad Trip Causes Isaac to suffer 1 heart of damage, including soul hearts. Turns into a Full Health pill when health is down to 1 red heart (Warning: Bad Trip will only turn into Full Health when your total health is down to one heart. In other words, Soul Hearts count). When playing as ???, Bad Trip will convert to a Full Health pill if he is at half a soul heart, rather than a full Soul Heart. Therefore, using it at a full Soul Heart will kill him. This can also happen with negative health (due to Devil Room deals) and 1 Soul Heart as any character.
Balls of Steel Gives the player 2 Soul Hearts. The Soul Hearts are directly added to Isaac's health instead of spawning on the floor.
Bombs Are Key Swaps the amount of bombs and keys in the player's inventory.
Explosive Diarrhea! (Oh No!) Causes Isaac to leave a short trail of lit Bombs, which do not deplete his current bomb count. (Cannot be obtained with Wrath of the Lamb v1.48. It can only be found in the base game, or v1.50 with the Unholy Edition)
Full Health Fully restores all heart containers. When playing as ??? and at less than 3 soul hearts, will restore health up to 3 soul hearts.
Health Down Decreases Heart Containers by 1. Changes to Health Up when at 1 heart container, regardless of current Soul Heart count.
Health Up Adds an empty Heart Container, and tints Isaac red.


This pill doesn't count as damage for the purpose of the No Damage Achievements.

I Found Pills (And ate Them!)

Isaac will make a "Durr..." sound and his appearance will change. (In Wrath of The Lamb, this pill is given one of two random effects: The original as shown below and "Puberty").

I Found Pills Isaac

Pretty Fly Adds a Orbital black fly, which blocks enemy shots and damages other Flies.
Range Down Decreases Range by 3.1.
Range Up Increases Range by 3.875. Tints Isaac blue.
Speed Down Decreases Speed by 0.24.
Speed Up Increases Speed by 0.3. Tints Isaac yellow.
Tears Down Decreases Tears by 0.28.
Tears Up Increases Tears by 0.35. Tints Isaac purple.
Telepills

Single-use version of the Teleport! item. May teleport to the I AM ERROR room, with a 1/15 (6.66%) chance.

Wrath of the LambEdit

Three new pills and four new effects are added in the Wrath of the Lamb expansion. These appear along with the previous pills/effects and are mixed in with the randomly assigned types and effects.

Pill Blue Green Ground Pill Blue Green Menu Pill Yellow Orange Ground Pill Yellow Orange Menu Pillwhitegrain Pillwhitegrainicon


Pill Name Effect
Luck Up Increases Luck. Tints Isaac green.
Luck Down Decreases Luck.
Friends Till The End! Gives you three Attack Flies, similar to the one spawned by The Mulligan.
Puberty Hair appears on Isaac's body.

Puberty Isaac

Items associated with PillsEdit

Lucky Foot

Lucky Foot Icon

Holding this item eliminates the possibility of finding Stat Down Pills when consuming an unidentified pill. Unidentified stat downs will count as stat up pills, allowing two different pills to have the same effect if generated as such.

Cain starts the game with this item.

Mom's Bottle Of Pills

Moms Bottle Of Pills Icon

When used, this item gives you a free pill. Recharges after clearing 6 rooms.

PHD

PHD Icon

Carrying the PHD will automatically identify unknown pills after a short delay and will also reverse stat down effects, making every stat down pill a stat up.

The Safety Cap

Safetycap

This Trinket, while held, slightly increases the odds of finding pills in chests and when completing a room.

Mom's Coin Purse

Moms Coin Purse Icon

Spawns 4 random pills.


NotesEdit

  • Bad Trip pills convert to full health pills when at 1 heart, unless you're playing as ???. If playing as ???, Bad Trip pills will convert when at one-half of a heart. Health Down pills convert into Health Up pills if you have one heart container.
  • Consuming the Bad Trip pill with ??? at one Soul Heart will kill him, unlike other characters. The icon on Isaac's Last Will will be a drop of blood, similar to the one seen by dying from a Blood Donation Machine.

BugsEdit

  • If you are in the Sacrifice room with Telepills and another item you want to keep, you can avoid using the door and still keep the second item by running into it and telepilling away. When you use the pills after running, you'll slide a bit. Use that slide to pick up the item.

TriviaEdit

  • The quote shown when picking up a pill, 'Pills Here!' is a reference to the character Louis from Left 4 Dead, who is highly known for catchy phrase said when picking up pain pills.
  • The sound effect that plays when a good pill effect occurs is the same sound effect that plays when a pill is obtained in Spewer, another of Edmund McMillen's games.
  • According to source code, Telepills is intended to have another 1/15 chance to teleport to Devil room/Angel room, but this doesn't work due to a bug.
  • The "Balls of Steel" effect is likely a reference to one of Duke Nukem's catchphrases.
    • It refers to the phrase that describes "having balls" as "having the confidence" for doing something, which reflects the concept behind soul hearts - faith.

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