Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
"Blood laser barrage"
Isaac's tears are replaced with a charged blood laser beam. The beam is piercing and spectral, dealing damage to all enemies and ignoring all obstacles in its path.
The laser deals damage equal to Isaac's damage and deals damage each tick.
Brimstone ticks 9 times in about 1 second.
Tears down: Delay * 3.
8 Inch Nails - Beams gain knockback, pushing enemies away in the direction they travel but not out of their path. This increases its consistency.
Almond Milk - Brimstone can be used without charging and will last indefinitely. The beam will also gain random worm trinket effects. Damage is significantly decreased. The beam can also be aimed in any direction with joystick controls.
Apple! - The beam can gain the damage multiplier from each of the items, although there is no visual difference. The bonus applies for the whole beam and not on a per-tick basis. Euthanasia loses its instant kill ability, however.
Euthanasia - The beam can gain the damage multiplier from each of the items, although there is no visual difference. The bonus applies for the whole beam and not on a per-tick basis. Euthanasia loses its instant kill ability, however.
Tough Love - The beam can gain the damage multiplier from each of the items, although there is no visual difference. The bonus applies for the whole beam and not on a per-tick basis. Euthanasia loses its instant kill ability, however.
Anti-Gravity - An orb of energy expands, then shrinks while firing the beam after a delay. The orb still hurts enemies if they touch it. Isaac can start charging a new shot immediately after releasing the fire key without canceling the first shot, effectively allowing for a faster firing rate. It makes it harder to hit enemies with Azazel as the beam does not increase in range.
Incubus: Isaac will fire Brimstone orbs, while Incubus will fire regular Brimstone beams.
Brain Worm - The beam will curve 90 degrees in order to attack opponents, effectively acting as a stronger form of homing.
Compound Fracture - Non-brimstone tears have a chance to split off from the beam with applicable stats and tear effects.
Cricket's Body - Non-brimstone tears have a chance to split off from the beam with applicable stats and tear effects.
Chocolate Milk - Brimstone laser takes longer to fully charge, but can be released at any point during its charge. Width and damage of the laser increases at higher charges.
Crooked Penny - Second Brimstone grants a much larger beam with a 1.2x damage multiplier and +1 damage. Any further Brimstones picked up will only grant +1 damage.
Diplopia - Second Brimstone grants a much larger beam with a 1.2x damage multiplier and +1 damage. Any further Brimstones picked up will only grant +1 damage.
Epic Fetus - Overrides Brimstone's charging effect, but missile explosions shoot ten beams in all directions, massively increasing damage and area of effect.
Explosivo - The beam has a chance to stick explosive tears to enemies.
Eye of the Occult - Brimstone will automatically charge, then attempt to hit the wall Isaac is facing before curving towards the crosshair.
Fire Mind - The beam will not cause explosions, but will still set enemies on fire.
Haemolacria - Increased charge time. Tears will burst into several beams that are fired in random directions.
Holy Light - The beam has a chance of summoning a row of Holy Light beams.
Hook Worm - Beam shifts left to right while firing straight and forms angles that constantly flatten and expand, effectively increasing its width.
Ipecac - The beam gains a poison effect. Upon hitting an enemy, wall or obstacle, the beam causes an explosion. +2 flat damage. Fire rate is unaffected.
The Ladder, when placed, will trigger the Ipecac-brimestone explosions.(possibly a bug)
Jacob's Ladder - Upon hitting an enemy, wall or obstacle, the beam generates sparks that home in on enemies.
Loki's Horns - Occasionally causes Isaac to fire the beam in all four cardinal directions, similarly to
The Ludovico Technique - The beam forms a large ring that is controllable and does not need to be charged. Enemies inside the ring without touching it are not hurt. The shot speed is ignored. The tears stat is ignored and the damage is dealt very rapidly at a rate equivalent to a 2 tear delay.
A Lump of Coal - The beam gradually increases in size and damage the farther it travels, with the damage increasing on a multiplier that is roughly +20% per tile of distance. This allows for a huge damage increase from longer distances.
Marked - Brimstone will automatically charge, then fire at the direction of the crosshair.
Mom's Eye - Adds a chance to shoot a beam from the back of Isaac's head.
Mom's Knife - Adds a small barrage of knives after the main knife is fired, with each knife doing 80% of Isaac's tear damage. The barrage of knives goes all the way across the screen and increases in quantity the longer the charge.
Mom's Wig - Holding down a fire button to charge the attack very rapidly rolls the probability to spawn blue spiders; releasing to fire the beam, however, does not.
Monstro's Lung - Fires 3-5 additional Brimstone beams in random directions around Isaac with no increase in charge time. Charging a new Brimstone beam removes the original from in front of Isaac, but not the additional ones added by Monstro's Lung. This effectively increases the fire rate.
Charging a new Brimstone beam will now remove all shot beams, but fire rate remains that of Brimstone.
Ocular Rift - Rifts may appear where the beam hits rocks, walls or enemies.
The Parasite - Upon hitting an enemy, wall or obstacle, two perpendicular beams split from the main beam at 90 degrees from the closest point of intersection.
Rubber Cement - Beams bounce off of walls, creating a second beam that deals half damage.
If Azazel's mini Brimstone beam bounces off a wall, it effectively becomes a full-length Brimstone beam, but it will still only deal half damage.
Azazel's Brimstone no longer becomes a full length beam after bouncing, instead bouncing as a regular mini-Brimstone.
Sad Bombs - Upon exploding, bombs release ten beams in all directions.
Brimstone does not benefit from Sad Bombs's flat damage bonus.