I stand corrected, the behaviour of the pills seems to be random. Also, if you take the pee upgrade you start smiling instead of crying, because you're peeing all over everything, but your range is significantly diminished. I question whether this is actually an upgrade, as I have not yet seen any significant change in the damage it does.
DiMono
Sins:
Rage: Runs around dropping bombs at you. Run and gun
Gluttony: Two attacks, apparently. First, when you're on a similar axis to him, he'll peel open his chest and fire a red beam at you. Second, he'll randomly shoot red blobs (I assume these are blood, actually) at you. There's a delay as he peels back his chest, so some cat and mouse will work, as will attacking on one axis while moving on the other in order to angle your shots
Random: You can fire your tears at both turds and fires to get rid of them. Sometimes they leave things behind.
Red pill: take immediately, as it increases your range
Blue pill: refills your health, so wait until you're low on health before taking it
What exactly does a "crack" look like for the secret room? Because I have yet to see one that isn't replicated in other rooms.