Ghost Pepper 
Effects
- (Removed in Repentance)Shooting tears sometimes spawns a fire similar to
Red Candle, damaging enemies and destroying shots it comes into contact with.
- (Added in Repentance)Shooting tears sometimes spawns a blue fire similar to
The Candle, damaging enemies and destroying shots it comes into contact with. It lasts on the ground for a limited time and can pass through obstacles.
- Creating farts through items/pills such as Re-Lax,
The Poop, 
Butter Bean, and etc. causes fire to shoot out alongside the fart.
- (Added in Repentance)The fire deals 3x to 6x of Isaac's damage, depending on the size of the flame.
- The fire can destroy Shopkeepers.
- Enemies with fire variants will change to their variants when they get hit with the flame.
Notes
- (Removed in Repentance) The chance of spawning fire is not affected by luck.
- (Added in Repentance) The fire is affected by luck. The activation rate is equal to 1/(12 - Luck). At base luck (0), the chance is 8.33%, maxing out at 50% at 10 luck.
Synergies
- (Added in Repentance)
Bird's Eye: Changes the activation rate to 1/(8 - Luck). At base luck (0), the chance is 12.5%, maxing out at 100% at 7 luck. Only one type of fire can be spawned at a time, however each flame has an equal chance of being launched.
- (Removed in Repentance)
Brimstone: The flames can still shoot from Isaac while holding the fire button.
- (Added in Repentance) Occasionally emits a flame while the beam is firing.
- Butter Bean,
Mega Bean, 
The Black Bean, 
Wait What?: Will spawn fires upon use/activation.
Dr. Fetus: Fires can be spawned while firing bombs.
Epic Fetus: Fires can be spawned while moving the crosshair.- (Added in Repentance)
Farting Baby: The familiar has a chance to spawn a flame upon farting.
Ipecac: Fires are spawned as normal and can be hit by Ipecac tears, making this especially dangerous with a multi-shot ability.
Mom's Knife: The flames can still shoot from Isaac while holding the fire button.
- (Added in Repentance)Occasionally spawns a fire when fired.
Monstro's Lung: The flames can still shoot from Isaac while holding the fire button.- The Poop: Fire will appear behind Isaac.
- (Added in Repentance)
Pupula Duplex: The fires gain a large size and duration increase.
Technology: Will occasionally spawn a fire. The lasers will not douse the flames.
Tech X: Will occasionally spawn a fire while firing lasers. Laser rings will not douse the flames.
Trisagion: Will occasionally spawn a fire while firing beams. Fires damage is not reduced.- (Added in Repentance)
Urn of Souls: Causes the Urn to emit Ghost Pepper's flames in addition to its regular flames.
Interactions
20/20/
The Inner Eye/
Mutant Spider: Will only spawn one fire.
Anti-Gravity: When holding down the fire button, when fire spawns it will be almost immediately put out by the clumps of tears.
Blood Clot: No effect.
Compound Fracture/
Cricket's Body/
The Parasite: Fires cannot split.- Homing tears: Flames will not be homing.
Incubus/(Added in Repentance)
Twisted Pair/(Added in Repentance)
Gello: Will not spawn fire by themselves, Isaac will spawn an additional fire instead of the familiar.
Lachryphagy: Feeding tears will quickly douse the flames.- (Added in Repentance) (Lilith) Lilith: Spawns fire from her mouth.
- (Removed in Repentance)
The Ludovico Technique: Fires created from Ghost Pepper will destroy the tear and cause it to respawn on Isaac.
- (Added in Repentance) Isaac now periodically creates fires that shoot towards the Ludovico Technique tear.
A Lump of Coal: Affects normal tears but no effect on fire.- (Removed in Repentance)
Pop!: Eyeballs tears quickly douse flames.
Proptosis: Flames will not lose damage or shrink as they travel.- (Removed in Repentance)
Soy Milk: No effect on frequency or damage of flames.
Sprinkler: The sprinkler will not spawn flames.