AcelRx Pharmaceuticals Reports First Quarter 2013 Financial Results

AcelRx Pharmaceuticals Reports First Quarter 2013 Financial Results

REDWOOD CITY, Calif.,

May 8, 2013 AcelRx Pharmaceuticals, Inc. (Nasdaq: ACRX), ( AcelRx ), a specialty pharmaceutical company focused on the development and commercialization of innovative therapies for the treatment of acute and breakthrough pain,

today reported financial results for the first quarter ended March 31, 2013.

We continue to make progress in clinical development

of our product candidates. We presented additional data at the recent American Society of Regional Anesthesia and Pain Medicine meeting from a head-to-head study of the Sufentanil NanoTab PCA System compared to intravenous morphine that showed rapid

post-operative pain reduction and low rates of oxygen desaturation for the NanoTab system treated patients, stated Richard King, president and CEO of AcelRx. This highly encouraging data reinforces our selection of sufentanil, a

fast-acting opioid with a high therapeutic index, to combine with our pre-programmed, non-invasive patient-controlled delivery technology. We also completed enrollment and look forward to announcing top-line results later this quarter from our third

and final Phase 3 trial conducted with the NanoTab System in patients who have undergone hip or knee replacement surgery. Mr. King added, We were also very pleased to announce positive Phase 2 top-line results for ARX-04, a

single-dose, sufentanil NanoTab product candidate administered by healthcare professionals for the management of moderate-to-severe acute pain, in which we successfully identified that a 30 mcg dose of sufentanil delivered no more frequently than

hourly is an effective dose.

First Quarter Financial Results

Net loss for the first quarter of 2013 was $12.8 million, or $0.34 per share, compared with a net loss of $7.1 million, or $0.36 per share for the first quarter of 2012. Common shares used in calculating

basic and diluted earnings per share were 37,133,358 for the first quarter of 2013 compared to 19,607,483 for the first quarter of 2012.

During the first quarters of 2013 and 2012, AcelRx recognized revenue of $940,000 and $329,000, respectively, resulting from reimbursement for work

completed under a research grant from the U.S. Army Medical Research and Materiel Command, or USAMRMC, for development of ARX-04, a sufentanil NanoTab product candidate for the treatment of moderate-to-severe acute pain in a range of ambulatory

Research and development, or R&D, expenses for the quarter ended March 31, 2013 totaled $9.3 million, compared with

$4.8 million for the quarter ended March 31, 2012. The increase was primarily due to expense associated with Phase 3 clinical studies of the Sufentanil NanoTab PCA System, AcelRx s lead product candidate for the treatment of post-operative

pain, and Phase 2 study expenses for the single-dose sufentanil NanoTab product candidate, ARX-04.

General and administrative expenses were

$2.2 million for the first quarter of 2013, compared with $2.1 million for the quarter ended March 31, 2012.

Other income and expense includes a $1.8 million non-cash charge in the first quarter of 2013 resulting from

the liability accounting related to the warrants issued in connection with the PIPE financing completed in June 2012. The primary determinant of this charge was an increase in stock price during the first quarter of 2013 and its resulting impact on

the Black-Scholes valuation of these warrants.

As of March 31, 2013, AcelRx had cash, cash equivalents and investments of $48.2 million,

compared to $59.8 million at December 31, 2012.

Review of Recent Accomplishments and Corporate Update

AcelRx records as revenue the reimbursement received pursuant to the $5.6 million USAMRMC grant received in 2011. To date, revenue from

this grant has been the only source of revenue recognized by AcelRx and we have recorded revenues of $4.4 million through March 31, 2013. We expect the remaining $1.2 million to be recorded as revenue over the remaining life of the grant, which

terminates on January 31, 2014.

We anticipate that research and development expenses for the remaining quarters of 2013 will be

substantially lower than the $9.3 million reported for the first quarter of 2013 due to lower clinical development expenses associated with our NanoTab System and ARX-04 programs. These decreases in R&D will be partially offset by the work

involved in the preparation of a New Drug Application for the Sufentanil NanoTab PCA System, expected to be submitted to the FDA in third quarter of 2013. Additionally, AcelRx anticipates modest increases in 2013 in general and administrative

expense due to costs associated with commercial preparations for the launch of the NanoTab System in the U.S. and expansion of its corporate infrastructure to support a commercial launch. Total operating expenses for 2013 are anticipated to be

modestly higher than they were in 2012.

Other income and expense in future periods is expected to include non-cash charges that result from

the liability accounting related to the warrants we issued in connection with the PIPE financing completed in the second quarter of 2012. The primary determinant of this charge is stock price change over each quarter and its impact on the

Black-Scholes valuation of these warrants. For this reason the impact in future periods is very difficult to predict and is not included in the Company s guidance.

AcelRx believes its current cash, cash equivalents and investments are sufficient to fund operations into the third quarter of 2014.

AcelRx will conduct a conference call and webcast today, May 8, at

4:30 p.m. Eastern time (1:30 p.m. Pacific time) to discuss its financial results and program updates. To listen to the conference call, dial in approximately ten minutes before the scheduled call to (800) 860-2442 for domestic callers,

(866) 605-3852 for Canadian callers, or (412) 858-4600 for international callers. Those interested in listening to the conference call live via the Internet may do so by visiting the Investors section of the company s website at

www.acelrx.com and selecting the Webcast link for the Q1 2013 earnings conference call. A webcast replay will be available on the AcelRx website for 90 days following the call by visiting the Investors section of the company s website at

About AcelRx Pharmaceuticals, Inc.

AcelRx Pharmaceuticals, Inc. is a specialty pharmaceutical company focused on the development and commercialization of innovative therapies for the treatment of acute and breakthrough pain. AcelRx s

lead product candidate, the Sufentanil NanoTab PCA System, or NanoTab System, is designed to solve the problems associated with post-operative intravenous patient-controlled analgesia which has been shown to cause harm to patients following surgery

because of the side effects of morphine, the invasive IV route of delivery and the complexity of infusion pumps. AcelRx has announced results from two Phase 3 clinical trials for the NanoTab System, and a third Phase 3 study has completed

enrollment, with data expected in the second quarter of 2013. A New Drug Application submission is planned for the third quarter of 2013. AcelRx recently announced positive top-line results for a Phase 2 trial for ARX-04, a sufentanil formulation

for the treatment of moderate-to-severe acute pain, funded through a grant from USAMRMC. The company has two additional pain treatment product candidates, ARX-02 and ARX-03, which have completed Phase 2 clinical development. For additional

information about AcelRx s clinical programs, please visit www.acelrx.com.

Forward Looking Statements

This press release contains forward-looking statements, including, but not limited to, statements related to future financial results, including 2013

financial guidance, the process and timing of anticipated future clinical development of AcelRx Pharmaceuticals product candidates, including the release of the Sufentanil NanoTab PCA System top-line clinical trial data, the release and

anticipated timing of additional NanoTab System clinical trial data, the potential submission of an NDA for NanoTab System and the timing thereof, therapeutic and commercial potential of NanoTab System and the anticipated timing and therapeutic and

commercial potential of other AcelRx Pharmaceuticals product candidates. These forward-looking statements are based on AcelRx Pharmaceuticals current expectations and inherently involve significant risks and uncertainties. AcelRx

Pharmaceuticals actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these risks and uncertainties, which include, without limitation, risks related to: that

fact that subsequent analyses of the data may lead to different (including less favorable) interpretations of the results than the analyses conducted to date or may identify important implications of the study that are not reflected in these

statements, or be subject to differing interpretations by the regulatory agencies; the uncertain clinical development process, including the risk that clinical trials, have an effective design, or have expected data available on schedule; any delays

or inability to obtain and maintain regulatory approval of its product candidates in the United States and Europe; its ability to attract funding partners or collaborators with development, regulatory and commercialization expertise; its ability to

obtain sufficient financing to complete registration of its product candidates in the United States and Europe; the market potential for its product candidates; the accuracy of AcelRx Pharmaceuticals estimates regarding expenses, capital

requirements and needs for financing; and other risks detailed in the Risk Factors and elsewhere in AcelRx Pharmaceuticals U.S. Securities and Exchange Commission filings and reports, including its Quarterly Report on Form 10-Q

filed with the SEC today on May 8, 2013. AcelRx Pharmaceuticals undertakes no duty or obligation to update any forward-looking statements contained in this release as a result of new information, future events or changes in its expectations.

Chief Financial Officer

SELECTED FINANCIAL DATA

(in thousands, except per share data)