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Ortho-Novum 777 is a triphasic oral contraceptive containing the synthetic estrogen ethinyl estradiol and the progestin norethindrone. It is indicated for the prevention of pregnancy. The triphasic regimen involves three distinct phases of hormone concentrations over a 21-day cycle, followed by a 7-day hormone-free interval, designed to mimic the natural menstrual cycle while maintaining contraceptive efficacy. The primary mechanism of action is the suppression of ovulation by inhibiting the release of gonadotropins (FSH and LH) from the pituitary gland. Additionally, it increases cervical mucus viscosity and alters the endometrial lining to further reduce the likelihood of conception and implantation. The drug was notably studied in the SELENA trial (Safety of Estrogens in Lupus Erythematosus - National Assessment) to assess its safety regarding disease flares in women with systemic lupus erythematosus (SLE).
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