Sec Form 4 Filing - Simon Farrell @ Trevi Therapeutics, Inc. - 2025-03-10

FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person Simon Farrell 2. Issuer Name and Ticker or Trading Symbol Trevi Therapeutics, Inc. [ TRVI] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) _____ Director _____ 10% Owner X __ Officer (give title below) _____ Other (specify below) Chief Commercial Officer (Last) (First) (Middle) C/O TREVI THERAPEUTICS, INC., 195 CHURCH STREET, 16TH FLOOR 3. Date of Earliest Transaction (MM/DD/YY) 03/10/2025 (Street) NEW HAVEN, CT06510 4. If Amendment, Date Original Filed (MM/DD/YY) 6. Individual or Joint/Group Filing (Check Applicable Line) __ X __ Form filed by One Reporting Person _____ Form filed by More than One Reporting Person (City) (State) (Zip)

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1.Title of Security (Instr. 3) 2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4) Code V Amount (A) or (D) Price Common Stock 03/10/2025 M( 1 ) 17,500 A $ 3.21 63,150 D Common Stock 03/10/2025 M( 1 ) 63,813 A $ 3.91 126,963 D Common Stock 03/10/2025 M( 1 ) 31,250 A $ 0.511 158,213 D Common Stock 03/10/2025 S( 2 ) 76,963 D $ 6.7276 ( 3 ) 81,250 D Common Stock 03/10/2025 S( 2 ) 4,350 D $ 7.1498 ( 4 ) 76,900 D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) 6. Date Exercisable and Expiration Date (MM/DD/YY) 7. Title and Amount of Underlying Securities (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4) Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares Performance Stock Option (right to buy) $ 2.38 03/10/2025 A 38,400 ( 5 ) 03/10/2025 02/14/2034 Common Stock 38,400 $ 0 38,400 D Performance Stock Option (right to buy) $ 3.21 03/10/2025 M 17,500 ( 6 ) 02/16/2031 Common Stock 17,500 $ 0 0 D Stock Option (right to buy) $ 3.91 03/10/2025 M 63,813 ( 7 ) 09/22/2030 Common Stock 63,813 $ 0 11,187 D Stock Option (right to buy) $ 0.511 03/10/2025 M 31,250 ( 8 ) 02/10/2032 Common Stock 31,250 $ 0 18,750 D

Reporting Owners Reporting Owner Name / Address Relationships Director 10% Owner Officer Other Simon Farrell C/O TREVI THERAPEUTICS, INC. 195 CHURCH STREET, 16TH FLOOR NEW HAVEN, CT06510 Chief Commercial Officer Signatures /s/ Christopher Galletta, attorney-in-fact 03/12/2025 Signature of Reporting Person Date

Explanation of Responses:

( 1 )This exercise of stock options was effected pursuant to a Rule 10b5-1 trading plan that was adopted on April 9, 2024. ( 2 )This sale was effected pursuant to a Rule 10b5-1 trading plan that was adopted on April 9, 2024. ( 3 )The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $6.14 to $7.13 inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth above. ( 4 )The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $7.14 to $7.16 inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth above. ( 5 )Reporting person was granted a performance-based stock option on February 15, 2024, to purchase 120,000 shares of common stock. The option vests based on the attainment of established performance criteria related to the timing and successful results of the Company's Phase 2b CORAL trial of Haduvio (nalbuphine ER) in patients with chronic cough in idiopathic pulmonary fibrosis, and Phase 2 RIVER trial of Haduvio in patients with refractory chronic cough. On March 10, 2025, the Compensation Committee of the Board of Directors of the Issuer certified that the performance metrics related to the successful results of the RIVER trial were satisfied, resulting in the vesting of the option as to 38,400 shares of common stock. The performance-based stock option remains eligible for vesting with respect to additional shares of common stock underlying the option in the event that performance metrics related to the successful results of the CORAL trial are satisfied. ( 6 )Reporting person was granted a performance-based stock option on February 17, 2021, to purchase 17,500 shares of common stock. The option vested based on the attainment of established performance criteria related to the timing and successful results of the Company's Phase 2b/3 PRISM trial of Haduvio for the treatment of prurigo nodularis, and Phase 2 CANAL trial of Haduvio for the treatment of chronic cough in patients with idiopathic pulmonary fibrosis. ( 7 )This option was granted on September 22, 2020. The 75,000 shares of common stock underlying the option vested as to 25% of the shares on September 22, 2021 and vested as to the remaining 75% of the shares in equal monthly installments thereafter through September 22, 2024. ( 8 )This option was granted on February 11, 2022. The 75,000 shares of common stock underlying the option vested as to 25% of the shares on February 11, 2023 and vest as to the remaining 75% of the shares in equal monthly installments thereafter through February 11, 2026.

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