The firm faces a precarious liquidity trajectory, evidenced by a negative free cash flow of $16.8 million in 2026Q1 and a rapid decline in cash reserves from $117.1 million in 2025Q2 to $19.4 million in 2026Q1.
| Cash from Operations | -45.3M | -42.09M | -38.26M | -31.71M | -28.18M | -28.95M | -29M | -23.09M | -18.29M | -7.97M | -11.19M |
| Operating CF Margin % | - | - | - | - | - | - | - | - | - | - | - |
| Operating CF Growth % | -33.92% | -10.02% | -20.64% | -12.55% | 2.66% | 0.19% | -25.58% | -26.25% | -129.35% | 28.74% | - |
| Net Income | -45.61M | -42.76M | -47.91M | -29.07M | -29.15M | -33.94M | -32.76M | -26.05M | -20.55M | -12.86M | -11.09M |
| Depreciation & Amortization | 141K | 144K | 147K | 123K | 43K | 50K | 47K | 39K | 23K | 4K | 4K |
| Stock-Based Compensation | 6.17M | 5.18M | 3.59M | 2.25M | 2.33M | 2.54M | 2.42M | 1.13M | 496K | 205K | 142 |
| Deferred Taxes | 0 | 0 | 0 | 0 | 0 | -82K | 0 | 0 | 0 | 1.35M | 0 |
| Other Non-Cash Items | -1.21M | -1.17M | -907K | -1.17M | -162K | 974K | 236K | 215K | 2.3M | 2.6M | 2.45M |
| Working Capital Changes | -4.79M | -3.49M | 6.83M | -3.85M | -1.23M | 1.51M | 1.06M | 1.58M | -568K | 722K | -1.49M |
| Change in Receivables | 0 | 0 | 0 | 0 | 0 | 0 | 293K | -374K | -135K | -30 | 49K |
| Change in Inventory | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Change in Payables | -88K | -598K | 1.6M | -1.05M | 9K | 831K | 417K | 777K | 66K | 92K | -1.11M |
| Cash from Investing | -67.19M | -94.11M | -21.53M | 59.43M | -107.37M | 0 | -32K | -9K | -158K | -13K | 0 |
| Capital Expenditures | -114K | -12K | -35K | -137K | -159K | 0 | -32K | -9K | -158K | -13K | 0 |
| CapEx % of Revenue | - | - | - | - | - | - | - | - | - | - | - |
| Acquisitions | 0 | 0 | 0 | 0 | -829K | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 981K | 1.64M | 1.37M | 0 | 829K | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Financing | 112.53M | 121.01M | 61.48M | -7.91M | 111.31M | 20.77M | 16.72M | 73.21M | 3.63K | 21.72M | 8.6M |
| Debt Issued (Net) | 0 | 0 | -126K | -9.41M | -5.83M | -68K | 14M | 0 | -4.81M | -8.25M | 8.6M |
| Equity Issued (Net) | 110.18M | 120.3M | 61.15M | 1.71M | 105.41M | 21.18M | 3.13M | 75.06M | 8.96M | 29.92M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -1.53M | 0 | 0 |
| Other Financing | 2.35M | 714K | 464K | -211K | 11.73M | -340K | -415K | -1.85M | -520K | 52K | 0 |
| Net Change in Cash | 38K | -15.18M | 1.7M | 19.81M | -24.24M | -8.17M | -12.31M | 50.11M | -14.82M | 13.73M | -2.6M |
| Free Cash Flow | -31.94M | -42.1M | -38.29M | -31.85M | -28.33M | -28.95M | -29.03M | -23.1M | -18.45M | -7.99M | -11.19M |
| FCF Margin % | - | - | - | - | - | - | - | - | - | - | - |
| FCF Growth % | 22.67% | -9.95% | -20.23% | -12.4% | 2.11% | 0.3% | -25.67% | -25.22% | -130.96% | 28.63% | - |
| FCF per Share | -0.22 | -0.29 | -0.38 | -0.32 | -0.44 | -1.27 | -1.61 | -1.30 | -2.06 | -0.89 | -0.69 |
| FCF Conversion (FCF/Net Income) | 0.70x | 0.98x | 0.80x | 1.09x | 0.97x | 0.85x | 0.89x | 0.89x | 0.89x | 0.62x | 1.01x |
| Interest Paid | 0 | 0 | 0 | 0 | 0 | 0 | 180K | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Imminent liquidity and dilution
As reported in financial statements, Trevi's operating cash flow consistently trails net income, with the OCF/NI ratio reaching 1.27 in 2026Q1, suggesting that non-cash expenses and working capital fluctuations are failing to bridge the gap between accounting losses and the actual cash required to sustain operations.
The consistent divergence between net income and operating cash flow indicates that the company's accounting losses are being compounded by cash-intensive operational requirements. Investors should monitor this trend, as the inability to achieve a neutral conversion ratio suggests that the firm's R&D-heavy business model remains fundamentally dependent on external capital injections.
Based on Trevi's reported figures, the company has sustained a negative free cash flow trajectory for nine of the last ten quarters, with the 2026Q1 cash outflow of $16.8 million highlighting the accelerating depletion of capital as the firm advances its late-stage clinical development programs.
The lack of positive free cash flow is an expected outcome for a pre-revenue biotech, yet the magnitude of the burn rate relative to the remaining cash balance warrants significant caution. This trajectory implies that the company is rapidly approaching a critical juncture where operational survival will necessitate either a major partnership or further dilutive equity financing.
According to recent SEC filings, Trevi's working capital changes have been highly erratic, swinging from a $5.4 million outflow in 2026Q1 to a $1.1 million inflow in 2025Q2, reflecting the lumpy nature of clinical trial payments and the absence of a stable, recurring revenue-based working capital cycle.
The volatility in working capital suggests that the company's cash position is highly sensitive to the timing of clinical trial milestones and vendor payments. This lack of predictability complicates cash forecasting and underscores the firm's vulnerability to sudden liquidity shocks during periods of intense trial activity.
As evidenced by the company's quarterly data, stock-based compensation has reached $2.2 million in 2026Q1, which effectively masks the true economic cost of operations by reducing the immediate cash burden while simultaneously creating significant long-term dilution for existing shareholders as the company struggles to retain talent.
While stock-based compensation is a standard tool for cash preservation in the biotech sector, its increasing scale relative to the total cash burn suggests that the company is relying heavily on equity-based incentives to manage its liquidity constraints. Analysts should interpret this as a signal that the firm is prioritizing short-term survival over the long-term preservation of shareholder equity.
Quick answers to the most common questions about buying TRVI stock.
Trevi Therapeutics, Inc. (TRVI) generated $-42.1M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Trevi Therapeutics, Inc. (TRVI) reported negative free cash flow of $42.1M in 2025, indicating capital requirements exceeded cash from operations.
Trevi Therapeutics, Inc. (TRVI) spent $0.0M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.