Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
"Chargeable burst attack"
Grants a charged shot that fires 14 tears in the same fashion as Monstro.
The attack can be released only when fully charged.
Tears down: Delay * 4.3.
Each tear has a random size multiplier between 0.9x to 1.33x, but there is no effect on damage.
Anti-Gravity - Tear delay down, which is greatly more effective due to Monstro's Lung's tear delay formula.
Blood Clot - All tears are larger, with increased damage (as opposed to every 2nd tear like Blood Clot alone)
Tears have a 50% chance to be Blood Clot tears.
Brimstone - Fires 3-5 additional Brimstone lasers in random directions around Isaac. It does not increase the charge time. This effect also applies to Azazel's version of Brimstone.
Chocolate Milk - Reduces Isaac's tear delay by 20%, and each tear from Monstro's Lung is a charged Chocolate Milk shot, massively increasing fire rate and damage.
This does not apply to Lilith's Incubus; picking up Chocolate Milk will significantly reduce damage and increase charge time.
Tear delay is increased, and the tear damage, along with the amount of tears fired is dependent on charge time.
Dr. Fetus - Isaac spits multiple bombs but must charge to fire. Bombs detonate simultaneously.
Flat Stone - All tears bounce simultaneously; the effective range is greatly increased.
Ipecac - Isaac spews multiple Ipecac tears, with no increase in charge time.
Charge time is greatly increased.
Mom's Knife - Fires an additional cluster of 3-5 knives when at maximum charge, each dealing 2x tear damage.
Tractor Beam - All the tears follow the beam at different heights without spreading out, making it much easier for multiple tears to hit a target.