Epic Fetus

Effects

Isaac's tears are replaced with guided missiles. Pressing the fire buttons spawns a crosshair that can be moved freely, summoning a missile to its position from above 1.5 seconds later.
- Missiles deal 20 times Isaac's damage.

Notes

(Removed in Repentance) Epic Fetus is a special item.
(Removed in Repentance) Epic Fetus overrides most items in the game and has the highest priority of all tear modifiers, over Brimstone and Mom's Knife.
Isaac's tear delay determines how quickly a new (set of) missile(s) can be fired after the previous one has landed. Barring very high tear delay, this has little effect on damage rate due to the delay of the missiles themselves.
Missiles benefit from some bomb modifier items, though at a lesser scale compared to Dr. Fetus.
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.
Epic Fetus missiles usually deal a full heart of damage to Isaac.
- Self-damage is only half a heart if the missile would deal less than 85 damage. In practice this is not common, as even a small damage stat increase will cause the missiles to go over the critical damage level.

Synergies

(Added in Afterbirth) 20/20/(Added in Afterbirth †) Bookworm/Conjoined/ Mutant Spider/ The Inner Eye: Fires a barrage of missiles.
(Added in Repentance) Bomber Boy: Missiles explode in a large cross-shaped blast, with each explosion dealing 0.75x times damage. 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.
(Added in Repentance) Blood Bombs: Every missile explosion leaves a large, lasting pool of red creep.
Blood Clot/ Chemical Peel: Each missile has a 50% chance to deal 20 or 40 points more damage, respectively.
Bob's Curse/ Scorpio: Missiles gain a poison effect.
- (Added in Repentance) Explosions leave behind a cloud of poison gas that will poison enemies in contact with it aside from the main target.
(Added in Afterbirth) Brimstone: Missile explosions shoot ten blood lasers in all directions.
(Added in Repentance) Brimstone Bombs: Missile explosions have a chance to shoot four Brimstone lasers in the cardinal directions. The chance scales with Isaac's luck.
Butt Bombs: Missile explosions will cloud up the screen, briefly confusing and dealing 10 damage to all enemies in the room.
Fire Mind/ Hot Bombs: Missile explosions leave behind a fire that damage enemies on contact. Fire Mind's burn effect is overridden.
(Added in Afterbirth †) (The Forgotten) The Forgotten: The charge attack is replaced by a missile in the Forgotten's hand and a crosshair that may be moved for an indefinite amount of time. The missile is thrown at the crosshair when all attack buttons are released, with an additional melee swing in the same direction. The melee attack is unaffected.
(Added in Afterbirth) Glitter Bombs: Missile explosions have a small chance of spawning pickups.
(Added in Afterbirth) Homing tears: The crosshair slowly slides towards enemies.
(Added in Afterbirth) Host Hat/Pyromaniac: Isaac becomes immune to his own airstrikes.
(Removed in Repentance) Ipecac: Missiles have a poison effect, have a larger blast radius and deal drastically increased damage, as the +40 damage from Ipecac is run through the damage multiplier of Epic Fetus.
- (Added in Repentance) Adds flat +2 damage instead of +40. Explosions leave behind a cloud of poison gas that will poison enemies in contact with it aside from the main target.
(Added in Repentance)(Lil Clot) Lil Clot / (Tainted Eve) Tainted Eve: The clots have their own targeting reticles and fire simultaneously with Isaac.
(Added in Afterbirth) Mom's Knife: Missile explosions shoot a ring of ten knives.
(Added in Afterbirth) Monstro's Lung: 2 to 4 additional crosshairs orbit the main crosshair, and missiles are fired onto each crosshair.
Mysterious Liquid: Every missile explosion leaves a small, lasting pool of creep.
(Added in Repentance) Nancy Bombs: Explosions have a chance to be affected by any of the bomb-modifier effects that synergize with Epic Fetus.
Polyphemus: Increased tear delay, but massively increases the missiles' blast radius and damage, as Polyphemus' damage multiplier is run through the damage multiplier of Epic Fetus.
Sad Bombs: Missile explosions fire ten tears in all directions. The shrapnel's damage is not run through the damage multiplier of Epic Fetus.
- (Added in Repentance) The chance for the effect to proc is dependent of Isaac's luck. Chance goes up to 100% at 30 luck.
(Added in Afterbirth) Strange Attractor: Enemies get drawn towards the crosshair.
(Added in Afterbirth / Removed in Repentance) Technology: Both fire normally. Missile explosions shoot ten Technology beams in all directions.
- (Added in Repentance) Missile explosions shoot ten Technology beams in all directions.
(Added in Afterbirth) Tech X: Missile explosions shoot ten Technology beams in all directions.

Interactions

(Added in Afterbirth) 8 Inch Nails: Missile explosions retain the knockback boost, so enemies that survive the blast will be knocked back far.
Anti-Gravity: Overridden by Epic Fetus. Stat effects are still applied.
(Azazel) Azazel/(Added in Repentance) (Tainted Azazel) Tainted Azazel: Azazel's mini-Brimstone/Tainted Azazel's thin Brimstone are overridden by Epic Fetus. There is no Brimstone burst on missile explosions.
Bobby-Bomb/(Added in Afterbirth / Removed in Repentance) Bomber Boy/(Added in Repentance) Ghost Bombs/ Mr. Mega/(Added in Afterbirth) Scatter Bombs/(Added in Afterbirth) Sticky Bombs: No effect.
(Removed in Afterbirth) Brimstone: Overridden by Epic Fetus.
(Removed in Repentance) Chocolate Milk: Reduces Isaac's tear delay by 20%. Missiles can't be charged.
- (Added in Repentance): Overridden by Epic Fetus.
Cursed Eye: Overridden by Epic Fetus.
Dr. Fetus: Overridden by Epic Fetus.
(Removed in Afterbirth) Godhead: Overridden by Epic Fetus.
- (Added in Afterbirth) Stat effects apply and the crosshair gains a homing effect, but missiles do not have a damaging aura.
(Removed in Afterbirth) Homing tears: Overridden by Epic Fetus.
(Added in Afterbirth / Removed in Repentance) Incubus: Incubus fires normal tears while the crosshair is being aimed.
- (Added in Repentance): Incubus fires a missile alongside Isaac's.
The Ludovico Technique: Overridden by Epic Fetus.
(Removed in Afterbirth) Monstro's Lung: Overridden by Epic Fetus.
(Removed in Afterbirth) Mom's Knife: Overridden by Epic Fetus.
(Added in Repentance) Mucormycosis: No effect.
The Parasite: No effect.
Tammy's Head/(Added in Afterbirth †) Varicose Veins/(Added in Repentance) It Hurts: Fires only normal tears, not missiles.
Soy Milk: Not recommended. Damage of missiles is drastically reduced, and unlike normal tears, the fire rate will not significantly increase.
(Added in Repentance) Spirit Sword: Overrides Epic Fetus.
(Removed in Afterbirth) Technology: Overridden by Epic Fetus.
(Removed in Afterbirth) Technology 2: Not recommended. Technology 2 is overridden by Epic Fetus, but the damage multiplier is still applied, massively reducing the missiles' damage.
- (Added in Afterbirth / Removed in Repentance) Both fire normally.
- (Added in Repentance) Does not reduce missiles' damage, and both fire normally at the cost of a slightly higher delay between each crosshair appearing.
Tiny Planet: Overridden by Epic Fetus.
(Added in Afterbirth) The Wiz: Makes two missiles drop in quick succession, and control of the crosshair is rotated 45 degrees clockwise. Not recommended, as it makes controlling the crosshair harder. However, mouse control is less affected.
(Added in Repentance) Twisted Pair: Each familiar will fire a missile from a two additional crosshairs. Not Recommended, as the twisted pair crosshairs are not synced to Isaac's crosshair and move at a much slower rate, making self damage much more likely as the additional crosshairs will struggle to make distance from Isaac.