Therefore, it is sometimes to good to use the item on its own first, then consume it. These two effects happen in order, which means that when you consume an active item, it will be consumed and then you'll also get one activation out of it. If you've collected a lot of effects, try to complete the run before quitting the game unless you're okay with losing them all. This is because the collected effects are not stored in the save file and only persist on a per-session basis. The Void will once again be a blank slate, just like at the start of the run.
that means items from the shop or devil deals will not count unless they have been paid for already (or have been doubled using Diplopia).