X0306 4 2019-11-02 0 0001427925 ACELRX PHARMACEUTICALS INC ACRX 0001511368 Hamel Lawrence G C/O ACELRX PHARMACEUTICALS, INC. 351 GALVESTON DRIVE REDWOOD CITY CA 94063 0 1 0 0 Chief Development Officer Common Stock 83382 D Common Stock 29795 I By the Hamel Revocable Living Trust Stock Option (Right to Buy) 2.225 2019-11-02 4 A 0 26125 0.00 A 2019-11-02 2028-11-02 Common Stock 26125 52250 D Balance includes non-reportable acquisition of 5,329 shares of Common Stock through the Company's Employee Stock Purchase Plan. On April 7, 2018, the reporting person was granted a performance-based option to purchase 52,250 shares of common stock, subject to the Company's achievement of commercial approval by the U.S. Food and Drug Administration ("FDA") of its new drug application for "DSUVIA" on or before February 15, 2019. Once the performance criteria is achieved, the option vests in two equal installments with 50% of the option vesting upon the Company's achievement of the performance criteria and the remaining 50% of the option vesting on the one-year anniversary of the date of such achievement, in all cases subject to continuous service to the Company. The performance criteria for commercial approval by the FDA for DSUVIA was met on November 2, 2018, resulting in vesting of the option as to 26,125 shares on that date. On November 2, 2019, the remaining balance of the option vested. Exhibit List - Exhibit 24.1 - Power of Attorney /s/ Martha Adler, Attorney-In-Fact 2019-11-04