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In comparison to the base game, the IPECAC Community Mod Modifies many items, enemies and mechanics previously existent. Here is a categorized list of them.

Bosses[edit | edit source]

Horsemen items[edit | edit source]

In addition to their usual drops, The Harbringers have unique drops. While not exclusive from them, each Horseman has one item that can be dropped from it instead of their usual rewards. These items are equally as likely to appear as the Horseman's other items, and, if said Horseman can drop either a Cube of Meat or a Ball of Bandages and the player already has at least one of either, it'll be dropped instead.

Challenges[edit | edit source]

No changes to Challenges were made yet

Transformations[edit | edit source]

Characters[edit | edit source]


His active item, Void, uses -2 less charges. If you had unlocked the Locust of Void achievement, he will start with that trinket too.


Has a chance to start the run with the related trinkets: The Egg, Crow Heart, Eve Bird's Foot, or Black Feather. When Eve gets hit, instead of 1 Dead Bird being triggered, 2 Dead Birds are triggered.


Holds the Missing Poster if you unlocked the "Isaac starts with missing poster" achievement.


Her damage is proportional to how much red hearts she has. Every half red heart gives her a .125 (estimated as 1.3 for the game) damage boost. This allows her to get a .88 damage boost from the start (7 [half red hearts from start] x .125 [damage from every half red hearts] = .875 [approximate to .88].


Starts out with Judas' Tongue if you unlocked the "Judas Starts with his tongue" achievement.


Her active item, Box of Friends, uses -2 less charges.

??? (Blue Baby)

Starts out with ???'s Soul if you unlocked the "??? Starts with his soul" achievement.

Items[edit | edit source]

Holy Water[edit | edit source]

Its creep's size and damage is now scaled with your Faith stat, if it is higher than your Evil.

Trinity Shield[edit | edit source]

Its size is now scaled with your Faith stat, if it is higher than your Evil.

Match Book[edit | edit source]

It now increases the spawn rate of bomb pickups accordingly to the Evil stat, if it is higher than Faith.

Shade[edit | edit source]

Now inflicts Fear on enemies it damages, and scales its damage with your Evil stat.

Safety Pin[edit | edit source]

Now increases your Shot Speed even more, scaling with your Evil stat.

Sulfuric Acid[edit | edit source]

Sulfuric Acid tears now instantly kill Stoneys, Grimaces and other stone-themed enemies. Other enemies are inflicted with Burning when hit by it.

Lil Gish[edit | edit source]

Now leaves a trail of black, slowing creep.

Stem Cells[edit | edit source]

Now drops the trinket Stem Cell.

Dead Bird[edit | edit source]

Now can drop one of the following trinkets: The Egg, Black Feather, Crow Heart, or Eve's Bird Foot.

Monsters[edit | edit source]

Mr. Mine[edit | edit source]


Has a unique sprite when out of the Flooded Caves -- Though this occurs on every floor, it is only ever seen naturally in the Womb, Utero and Scarred Womb.

Objects[edit | edit source]

Mom's Dressing Table[edit | edit source]

For each dressing table destroyed, the player is inflicted with -0.77 Luck. This is intended to counteract the benefits of blowing them up by linking it to a long-term disadvantage. When destroyed, the dressing table now also has a chance to drop the trinket Mirror Shard.

Pickups[edit | edit source]

Trinkets[edit | edit source]

Achievements[edit | edit source]

Miscellaneous[edit | edit source]

  • Black tar creep (Like from Ball of Tar, or the above Little Gish change) now sets on fire from explosions and from being close to a lit Fireplace. This fire does damage to enemies.