Serpent's Kiss

Effects

Grants a chance to fire poison tears, each tick dealing damage equal to Isaac's.
- Poison from the shots will tick 2 times.
Inflicts poison on enemies who make contact with Isaac.
- Contact poison will tick 6 times.
(Removed in Repentance) Enemies who are killed after they have been inflicted with this type of poison have a 20% chance to drop black hearts.
- (Added in Repentance) Only applies to enemies after being inflicted with contact poison.
- Enemies still can drop black hearts if the poison has worn off

Not affected by luck.
The contact poison effect of this item is identical to The Virus.
Enemies and bosses with multiple segments, such as Chub and Larry Jr., have a chance to drop multiple Black Hearts.
The enemy does not need to be killed by the poison or still be poisoned when killed for the Black Hearts to drop.
(Removed in Afterbirth †) Although Stonies and Shopkeepers can't be visibly poisoned, they still can drop Black Hearts if destroyed after being touched.
If a boss would have been poisoned, but negates it with status immunity, they can still drop a black heart.

(Removed in Repentance) Dr. Fetus / Epic Fetus: Bombs and missiles may become poisonous, and enemies hit by them may drop black hearts.
Invulnerability: Contact while invincible poisons enemies (Added in Repentance) Enabling black heart drops
(Removed in Repentance) Mom's Knife: Enemies poisoned by the knife may drop black hearts.
(Added in Repentance) Mars: Dashing into enemies will often both kill enemies, and cause them to drop black hearts.
(Tainted Forgotten) Tainted Forgotten: Especially strong as you are likely to apply contact poison when attacking enemies, giving you black hearts frequently.

Godhead: The Godhead aura cannot inflict poison but the tears themselves may poison enemies on contact.
(Removed in Repentance) The following interactions are trivial in Repentance:
- Athame / Maw of the Void: The black rings may poison enemies but do not generate black hearts.
- Brimstone: The blood barrage may poison enemies but does not generate black hearts.
- Tech.5 / Tech X / Technology / Technology 2: The lasers may poison enemies but do not generate black hearts.
- (Added in Afterbirth †) Trisagion: May poison enemies but does not generate black hearts.