Pills

Pickups
Hearts	Coins	Bombs	Keys	Batteries	Pills	Cards	Runes	Objects			Chests	Sacks
								Glass Dice	Trial Discs	Miscellaneous Objects

Pills are pickups that may provide beneficial or inhibiting effects when used. They take up the same slot as cards, runes and objects when picked up. Their effects can be mimicked by Placebo.

At the start of each run, a set of 13 random pill effects (known as the "pill pool" of the run) are selected and assigned to the various sprites of pills. Pills are usually unidentified until consumed. Pills may be identified or change their effect depending on various conditions.

Fiend Folio adds 9 new pill effects, along with various new appearances for pills.

This page is about Pills added in Fiend Folio. More information about Pills in general can be found in the vanilla page.

Pill Effects

Name	Polarity	Class	Mimic Charge	Effect	Horse Pill Effect
Melatonin	+	1		Makes all enemies in the room drowsy, causing them to be put to sleep for 4 seconds. Applies the Curse of Darkness effect to the room for 6 seconds.	Enemies are put to sleep for 8 seconds, darkness lasts for 10 seconds.
Holy $#!&	+	2		Spawns a White Poop.	Spawns 2 White Poops.
Haemorrhoids	−	1		Spawns a Red Poop a short distance away from Isaac.	Spawns 2 Red Poops.
Fish Oil	+	0		Increases Isaac's tear size.	Tear size increase is doubled.
Lemon Juice	−	0		Reduces Isaac's tear size.	Tear size decrease is doubled.
Epidermolysis	−	1		Halves the invincibility frames Isaac gets after being hurt. Effect ends upon leaving the current room.	Isaac's invincibility frames are reduced even further.
Clairvoyance	+	2		Removes the current Curse on the floor, excluding Curse of the Labyrinth.	No difference.
Spider Unboxing	+	0		Spawns various friendly spider enemies: 2 Spiders 10 Baby Spiders Creates a Cobweb under Isaac.	Spawns a larger array of spiders: 4 Spiders 18 Baby Spiders 2 Level 2 Spiders
Cyanide!	N	1		All stats up. Starts a timer at 60 seconds that kills Isaac when it hits 0. Both effects are cancelled when another pill that isn't Cyanide is used. Using another Cyanide Pill stacks the stat boosts, but reduces the remaining time. Cyanide Pills can only appear with Deadly Dose.	Activates the effects of Cyanide! twice, giving double the stats but starts the death timer at 40 seconds.

Pill Colors

Fiend Folio: Reheated also added new pill colors to memorize! These have a chance of appearing in place of the regular vanilla pill colors encountered.

• Main article: Vanilla Tweaks

Note: These new pill colors are purely cosmetic; they do not correlate to the types of possible pill effects, nor number of pill effects that appear in the pill pool, which will always remain at 13 per run.

Pill Colors

Cyanide Pills

Cyanide Pills are pills that are exclusively found from the effect of Deadly Dose. Consuming a Cyanide Pill will activate the Cyanide! effect, which grants a +50% damage multiplier, +43% tear rate multiplier, +0.05 speed and +0.62 range, but will start a 60-second countdown which appears near Isaac's feet that will instantly kill Isaac upon reaching 0. The effect will end once Isaac takes a normal pill, which will stop the timer and remove the stat boosts. While the Cyanide Pill's effect is active, room clear rewards have a chance to be replaced with a random pill. Taking additional Cyanide Pills while already under the effect of Cyanide! will double the stat boosts, but will also decrease the remaining time before Isaac dies.

Cyanide Pills can come in Golden and Horse Pill variants:

• Cyanide Horse Pills activates the effect of Cyanide! twice.

• Golden Cyanide Pills can be used multiple times and have a chance to disappear on each use.

• Golden Cyanide Horse Pills have the effects of both Golden Cyanide Pills and Cyanide Horse Pills.

Trivia

• The announcer's voice line for Holy $#!&'s horse pill effect uses the "fart with reverb" sound effect that has been used often in many different meme edits for comedic effect.
• The Spider Unboxing pill effect is a reference to a "shock gif" of a person tearing open a spider egg sack with many baby spiders crawling out, that has been captioned "spider unboxing".
• The Fish Oil and Lemon Juice pill effects and their effects are a possible reference to the Snake Oil and Lemon Head items from the Retribution MOD, as both increase and decrease the size of the player's tears respectively.
• Epidermolysis is a skin condition that causes the skin to be weaker and easily blister from minor injuries or irritation.