David Bharucha - 12 Dec 2025 Form 4 Insider Report for Milestone Pharmaceuticals Inc. (MIST)

Role: Chief Medical Officer
Signature: /s/ Joseph Oliveto, Attorney-in-Fact
Issuer symbol: MIST
Transactions as of: 12 Dec 2025
Net transactions value: -$158,209
Form type: 4
Filing time: 28 Jan 2026, 18:30:12 UTC
Previous filing: 15 Jul 2025
Next filing: 05 Feb 2026
SEC: View on sec.gov

Reporting Owners (1)

Name	Relationship	Address	Signature	Signature date	CIK
Bharucha David	Chief Medical Officer	C/O MILESTONE PHARMACEUTICALS INC., 1111 DR. FREDERIK-PHILIPS BLVD, STE 420, MONTREAL, QUEBEC, CANADA	/s/ Joseph Oliveto, Attorney-in-Fact	28 Jan 2026	0001910985

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	MIST	Common Shares	Award		+100,000	+158%		163,333	12 Dec 2025	Direct	F1, F2
transaction	MIST	Common Shares	Sale	$134,576	-58,007	-36%	$2.32	105,326	15 Dec 2025	Direct	F3, F4
transaction	MIST	Common Shares	Options Exercise		+20,100	+19%		125,426	26 Jan 2026	Direct	F5
transaction	MIST	Common Shares	Sale	$23,633	-12,245	-9.8%	$1.93	113,181	26 Jan 2026	Direct	F3, F4

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	MIST	Employee Stock Option (right to buy)	Award	$0	+100,000		$0.000000	100,000	12 Dec 2025	Common Shares	100,000	$1.74	Direct	F6
transaction	MIST	Restricted Stock Units	Options Exercise	$0	-20,100	-25%	$0.000000	60,300	26 Jan 2026	Common Shares	20,100		Direct	F5, F7

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Represents a performance stock unit ("PSU") award that vested upon the certification by the Compensation Committee of the Board of Directors of the Issuer that the U.S. Food and Drug Administration has provided a New Drug Application Approval Letter granting approval of Cardamyst (etripamil).
F2	Each PSU represents a contingent right to receive one common share.
F3	Represents shares sold pursuant to a sell-to-cover arrangement for the purpose of satisfying income tax liabilities incurred upon vesting of PSUs or restricted stock unit ("RSU") awards only, respectively.
F4	The price reported is a weighted average price. These shares were sold in multiple transactions. 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 in this footnote.
F5	Each RSU represents a contingent right to receive one common share.
F6	50% of the option will vest on June 12, 2026 and 50% will vest on December 12, 2026, subject to the Reporting Person continuing to provide service through each such date.
F7	One-fourth (1/4th) of the shares subject to the RSU award vested or will vest on each of January 26, 2026, January 26, 2027, January 26, 2028 and January 26, 2029, subject to the Reporting Person continuing to provide service through each such date.