Bob's Curse/ Scorpio: Missiles gain a poison effect.Blood Clot/ Chemical Peel: Each missile has a 50% chance to deal 20 or 40 points more damage, respectively.Blood Bombs: Every missile explosion leaves a large, lasting pool of red creep.Unlike with regular bombs, getting hit by every separate explosion from Epic Fetus won't decrease the damage for each successive explosion, drastically increasing damage. Bomber Boy: Missiles explode in a large cross-shaped blast, with each explosion dealing 0.75x times damage.20/20/ Bookworm/ Conjoined/ Mutant Spider/ The Inner Eye: Fires a barrage of missiles.In practice this is not common, as even a small damage stat increase will cause the missiles to go over the critical damage level. Self-damage is only half a heart if the missile would deal less than 85 damage.Epic Fetus missiles usually deal a full heart of damage to Isaac.Stacking multiple copies of the item causes a barrage of missiles in quick succession without resetting the crosshair's position, up to sixteen at a time.Missiles benefit from some bomb modifier items, though at a lesser scale compared to Dr.Barring very high tear delay, this has little effect on damage rate due to the delay of the missiles themselves. Isaac's tear delay determines how quickly a new (set of) missile(s) can be fired after the previous one has landed.Epic Fetus overrides most items in the game and has the highest priority of all tear modifiers, over Brimstone and Mom's Knife.Pressing the fire buttons spawns a crosshair that can be moved freely, summoning a missile to its position from above 1.5 seconds later. Isaac's tears are replaced with guided missiles.

Op binding of isaac seeds