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    SEC Form 10-Q filed by Tenax Therapeutics Inc.

    8/13/25 4:22:36 PM ET
    $TENX
    Biotechnology: Pharmaceutical Preparations
    Health Care
    Get the next $TENX alert in real time by email
    10-Q
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    Table of Contents

     

    UNITED STATES

    SECURITIES AND EXCHANGE COMMISSION

    Washington, D.C. 20549

     

    FORM 10-Q

     

    ☒

    QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

     

    FOR THE QUARTERLY PERIOD ENDED June 30, 2025

     

    OR

     

    ☐

    TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

     

    FOR THE TRANSITION PERIOD FROM TO

     

    Commission File Number 001-34600

     

    TENAX THERAPEUTICS, INC.

    (Exact name of registrant as specified in its charter)

     

    Delaware

    26-2593535

    (State of incorporation)

    (I.R.S. Employer Identification No.)

     

    101 Glen Lennox Drive, Suite 300, Chapel Hill, North Carolina 27517

    (Address of principal executive offices, including zip code)

     

    (919) 855-2100

    (Registrant’s telephone number, including area code)

     

    Securities registered pursuant to Section 12(b) of the Act:

     

    Title of each class

    Trading Symbol(s)

    Name of each exchange on which registered

    Common Stock, $0.0001 par value per share

    TENX

    The Nasdaq Stock Market LLC

     

    Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

    Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

    Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

     

    Large Accelerated filer

    ☐

    Accelerated filer

    ☐

    Non-accelerated Filer

    ☒

    Smaller reporting company

    ☒

    Emerging growth company

    ☐

     

    If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

    Indicate by check mark whether the registrant is a shell company (as defined by Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

    As of August 11, 2025, the registrant had outstanding 4,562,500 shares of Common Stock.

     

     


    Table of Contents

     

    TABLE OF CONTENTS

     

     

    PAGE

    PART I. FINANCIAL INFORMATION

     

    Item 1.

    Financial Statements

    3

     

    Condensed Consolidated Balance Sheets as of June 30, 2025 (Unaudited) and December 31, 2024

    3

    Condensed Consolidated Statements of Operations (Unaudited) for the Three and Six Months Ended June 30, 2025 and 2024

    4

     

    Condensed Consolidated Statements of Stockholders’ Equity (Unaudited) for the Three and Six Months Ended June 30, 2025 and 2024

    5

     

    Condensed Consolidated Statements of Cash Flows (Unaudited) for the Six Months Ended June 30, 2025 and 2024

    6

     

    Notes to Condensed Consolidated Financial Statements (Unaudited)

    7

    Item 2.

    Management’s Discussion and Analysis of Financial Condition and Results of Operations

    15

    Item 3.

    Quantitative and Qualitative Disclosures About Market Risk

    20

    Item 4.

    Controls and Procedures

    20

     

     

     

    PART II. OTHER INFORMATION

     

    Item 1.

    Legal Proceedings

    21

    Item 1A.

    Risk Factors

    21

    Item 6.

    Exhibits

    22

    SIGNATURES

    23

    2


    Table of Contents

     

    PART I - FINANCIAL INFORMATION

    ITEM 1. FINANCIAL STATEMENTS

    TENAX THERAPEUTICS, INC.

    CONDENSED CONSOLIDATED BALANCE SHEETS

    (Amounts in thousands, except share and per share data)

     

     

     

    June 30, 2025

     

     

    December 31, 2024

     

     

     

    (unaudited)

     

     

     

     

    ASSETS

     

     

     

     

     

     

    Current assets

     

     

     

     

     

     

    Cash and cash equivalents

     

    $

    105,462

     

     

    $

    94,851

     

    Prepaid expenses and other current assets

     

     

    395

     

     

     

    1,835

     

    Total current assets

     

     

    105,857

     

     

     

    96,686

     

    Total assets

     

    $

    105,857

     

     

    $

    96,686

     

    LIABILITIES AND STOCKHOLDERS’ EQUITY

     

     

     

     

     

     

    Current liabilities

     

     

     

     

     

     

    Accounts payable

     

    $

    562

     

     

    $

    3,157

     

    Accrued liabilities

     

     

    1,965

     

     

     

    1,536

     

    Total current liabilities

     

     

    2,527

     

     

     

    4,693

     

    Total liabilities

     

     

    2,527

     

     

     

    4,693

     

     

     

     

     

     

     

     

    Commitments and contingencies; see Note 4

     

     

     

     

     

     

    Stockholders' equity

     

     

     

     

     

     

    Preferred stock, undesignated, authorized 4,818,654 shares

     

     

     

     

     

     

    Series A Preferred stock, par value $0.0001, authorized 5,181,346 shares; issued and outstanding 210, as of June 30, 2025 and December 31, 2024

     

     

    -

     

     

     

    -

     

    Common stock, par value $0.0001 per share; authorized 400,000,000 shares; issued and outstanding 4,148,495 as of June 30, 2025 and 3,420,906 as of December 31, 2024, respectively

     

     

    -

     

     

     

    -

     

    Additional paid-in capital

     

     

    439,440

     

     

     

    406,848

     

    Accumulated deficit

     

     

    (336,110

    )

     

     

    (314,855

    )

    Total stockholders’ equity

     

     

    103,330

     

     

     

    91,993

     

    Total liabilities and stockholders' equity

     

    $

    105,857

     

     

    $

    96,686

     

     

    The accompanying notes are an integral part of these condensed consolidated financial statements.

    3


    Table of Contents

     

    TENAX THERAPEUTICS, INC.

    CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

    (unaudited)

    (Amounts in thousands, except share and per share data)

     

     

     

    For the three months ended June 30,

     

     

    For the six months ended June 30,

     

     

     

     

    2025

     

     

    2024

     

     

    2025

     

     

    2024

     

     

    Operating expenses

     

     

     

     

     

     

     

     

     

     

     

     

     

    Research and development

     

    $

    6,121

     

     

    $

    2,327

     

     

    $

    11,804

     

     

    $

    5,003

     

     

    General and administrative

     

     

    5,671

     

     

     

    1,344

     

     

     

    11,326

     

     

     

    2,577

     

     

    Total operating expenses

     

     

    11,792

     

     

     

    3,671

     

     

     

    23,130

     

     

     

    7,580

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Net operating loss

     

     

    (11,792

    )

     

     

    (3,671

    )

     

     

    (23,130

    )

     

     

    (7,580

    )

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Interest income

     

     

    954

     

     

     

    104

     

     

     

    1,884

     

     

     

    222

     

     

    Interest expense

     

     

    -

     

     

     

    (9

    )

     

     

    -

     

     

     

    (17

    )

     

    Other income (expense), net

     

     

    (9

    )

     

     

    1

     

     

     

    (9

    )

     

     

    1

     

     

    Net loss

     

    $

    (10,847

    )

     

    $

    (3,575

    )

     

    $

    (21,255

    )

     

    $

    (7,374

    )

     

    Net loss per share, basic and diluted

     

    $

    (0.27

    )

     

    $

    (1.83

    )

     

    $

    (0.56

    )

     

    $

    (4.65

    )

     

    Weighted average number of common shares and prefunded warrants outstanding, basic and diluted

     

     

    39,572,177

     

     

     

    1,958,245

     

     

     

    38,086,800

     

     

     

    1,586,650

     

     

     

    The accompanying notes are an integral part of these condensed consolidated financial statements.

    4


    Table of Contents

     

    TENAX THERAPEUTICS, INC.

    CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

    (unaudited)

    (Amounts in thousands, except share data)

     

     

     

    Preferred Stock

     

     

    Common Stock

     

     

     

     

     

     

     

     

     

     

     

     

    Number of Shares

     

     

    Amount

     

     

    Number of Shares

     

     

    Amount

     

     

    Additional paid-in capital

     

     

    Accumulated deficit

     

     

    Total stockholders' equity

     

    Balance at December 31, 2023

     

     

    210

     

     

    $

    -

     

     

     

    298,281

     

     

    $

    -

     

     

    $

    305,351

     

     

    $

    (297,253

    )

     

    $

    8,098

     

    Public offering sale of common stock, warrants, and prefunded warrants, net of offering costs of $1,028

     

     

    -

     

     

     

    -

     

     

     

    421,260

     

     

     

    -

     

     

     

    8,010

     

     

     

    -

     

     

     

    8,010

     

    Exercise of pre-funded warrants for cash

     

     

    -

     

     

     

    -

     

     

     

    973,240

     

     

     

    -

     

     

     

    1

     

     

     

    -

     

     

     

    1

     

    Exercise of pre-funded warrants, cashless

     

     

    -

     

     

     

    -

     

     

     

    205,467

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

    Stock split and fractional shares issued

     

     

    -

     

     

     

    -

     

     

     

    59,997

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

    Stock-based compensation expense

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    119

     

     

     

    -

     

     

     

    119

     

    Net loss

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    (3,799

    )

     

     

    (3,799

    )

    Balance at March 31, 2024

     

     

    210

     

     

    $

    -

     

     

     

    1,958,245

     

     

    $

    -

     

     

    $

    313,481

     

     

    $

    (301,052

    )

     

    $

    12,429

     

    Stock-based compensation expense

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    22

     

     

     

    -

     

     

     

    22

     

    Net loss

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    (3,575

    )

     

     

    (3,575

    )

    Balance at June 30, 2024

     

     

    210

     

     

    $

    -

     

     

     

    1,958,245

     

     

    $

    -

     

     

    $

    313,503

     

     

    $

    (304,627

    )

     

    $

    8,876

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Balance at December 31, 2024

     

     

    210

     

     

    $

    -

     

     

     

    3,420,906

     

     

    $

    -

     

     

    $

    406,848

     

     

    $

    (314,855

    )

     

    $

    91,993

     

    Public offering sale of common stock and prefunded warrants, net of offering costs of $1,746

     

     

    -

     

     

     

    -

     

     

     

    378,346

     

     

     

    -

     

     

     

    23,216

     

     

     

    -

     

     

     

    23,216

     

    Exercise of pre-funded warrants

     

     

    -

     

     

     

    -

     

     

     

    99,189

     

     

     

    -

     

     

     

    1

     

     

     

    -

     

     

     

    1

     

    Exercise of warrants

     

     

    -

     

     

     

    -

     

     

     

    71,944

     

     

     

    -

     

     

     

    347

     

     

     

    -

     

     

     

    347

     

    Stock-based compensation expense

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    4,142

     

     

     

    -

     

     

     

    4,142

     

    Net loss

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    (10,408

    )

     

     

    (10,408

    )

    Balance at March 31, 2025

     

     

    210

     

     

    $

    -

     

     

     

    3,970,385

     

     

    $

    -

     

     

    $

    434,554

     

     

    $

    (325,263

    )

     

    $

    109,291

     

    Exercise of pre-funded warrants

     

     

    -

     

     

     

    -

     

     

     

    116,693

     

     

     

    -

     

     

     

    1

     

     

     

    -

     

     

     

    1

     

    Exercise of warrants

     

     

    -

     

     

     

    -

     

     

     

    61,417

     

     

     

    -

     

     

     

    276

     

     

     

    -

     

     

     

    276

     

    Stock-based compensation expense

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    4,609

     

     

     

    -

     

     

     

    4,609

     

    Net loss

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    -

     

     

     

    (10,847

    )

     

     

    (10,847

    )

    Balance at June 30, 2025

     

     

    210

     

     

    $

    -

     

     

     

    4,148,495

     

     

    $

    -

     

     

    $

    439,440

     

     

    $

    (336,110

    )

     

    $

    103,330

     

     

     

    The accompanying notes are an integral part of these condensed consolidated financial statements.

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    TENAX THERAPEUTICS, INC.

    CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

    (unaudited)

    (Amounts in thousands)

     

     

     

    Six months ended June 30,

     

     

     

    2025

     

     

    2024

     

     

     

     

     

     

     

     

    CASH FLOWS FROM OPERATING ACTIVITIES

     

     

     

     

    Net Loss

     

    $

    (21,255

    )

     

    $

    (7,374

    )

    Adjustments to reconcile net loss to net cash used in operating activities

     

     

     

     

     

     

    Interest on debt instrument

     

     

    -

     

     

     

    17

     

    Stock-based compensation

     

     

    8,751

     

     

     

    141

     

    Changes in operating assets and liabilities

     

     

     

     

     

     

    Prepaid expenses and other current assets

     

     

    1,440

     

     

     

    659

     

    Accounts payable

     

     

    (2,595

    )

     

     

    (1,221

    )

    Accrued liabilities

     

     

    429

     

     

     

    (419

    )

    Net cash used in operating activities

     

     

    (13,230

    )

     

     

    (8,197

    )

     

     

     

     

     

     

     

    CASH FLOWS FROM INVESTING ACTIVITIES

     

     

     

     

     

     

    Net cash provided by investing activities

     

     

    -

     

     

     

    -

     

     

     

     

     

     

     

    CASH FLOWS FROM FINANCING ACTIVITIES

     

     

     

     

     

     

    Proceeds from issuance of warrants and pre-funded warrants, net of issuance costs

     

     

    23,216

     

     

     

    8,011

     

    Proceeds from the exercise of warrants and pre-funded warrants

     

     

    625

     

     

     

    -

     

    Payments on short-term note

     

     

    -

     

     

     

    (222

    )

    Net cash provided by financing activities

     

     

    23,841

     

     

     

    7,789

     

     

     

     

     

     

     

     

    Net change in cash and cash equivalents

     

     

    10,611

     

     

     

    (408

    )

    Cash and cash equivalents, beginning of period

     

     

    94,851

     

     

     

    9,792

     

    Cash and cash equivalents, end of period

     

    $

    105,462

     

     

    $

    9,384

     

     

     

     

     

     

     

     

    Supplemental Disclosures:

     

     

     

     

     

     

    Cash paid for interest

     

    $

    -

     

     

    $

    17

     

     

    The accompanying notes are an integral part of these condensed consolidated financial statements.

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    TENAX THERAPEUTICS, INC.

    NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

    (unaudited)

    NOTE 1. DESCRIPTION OF BUSINESS

    Tenax Therapeutics, Inc., together with its subsidiaries (collectively “Tenax” or the “Company”), is a Phase 3, development-stage pharmaceutical company using clinical insights to develop novel cardiopulmonary therapies.

    The Company is incorporated in Delaware and is headquartered in Chapel Hill, North Carolina.

    Liquidity and Capital Resources

    The Company has financed its operations since September 1990 primarily through the sale of equity and debt securities and loans from stockholders. The Company had an accumulated deficit of $336.1 million at June 30, 2025 and incurred losses of $21.3 million and $7.4 million during the six months ended June 30, 2025 and 2024, respectively. The Company expects to continue to incur expenses related to the development of levosimendan for pulmonary hypertension and other potential indications and, over the long term, imatinib for pulmonary arterial hypertension (“PAH”), as well as identifying and developing other potential product candidates. At June 30, 2025, the Company had cash and cash equivalents of $105.5 million. Based on its resources on June 30, 2025, Company management believes that it has sufficient funds for the Company to continue its operations over at least the next 12 months from the date these condensed consolidated financial statements were available to be issued.

    To the extent that the Company raises additional funds by issuing shares of its common stock or other securities convertible or exchangeable for shares of common stock, stockholders will experience dilution, which may be significant. In the event the Company raises additional capital through debt financings, the Company may incur significant interest expense and become subject to restrictive covenants in the related transaction documents that may affect the manner in which the Company conducts its business. To the extent that the Company raises additional funds through collaboration and licensing arrangements, it may be necessary to relinquish some rights to its technologies or product candidates or grant licenses on terms that may not be favorable to the Company. Any or all of the foregoing may have a material adverse effect on the Company’s business and financial performance.

     

    NOTE 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

    Basis of Presentation and Principles of Consolidation

    The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with GAAP for interim financial information and the instructions to Form 10‑Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by GAAP for complete financial statements. In the opinion of management, the unaudited condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and footnote disclosures normally included in the Company’s annual financial statements prepared in accordance with GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.

    The accompanying unaudited condensed consolidated financial statements and related disclosures have been prepared with the presumption that users of the unaudited condensed consolidated financial statements have read or have access to the audited financial statements for the preceding fiscal year. Accordingly, these unaudited condensed consolidated financial statements should be read in conjunction with the Company’s Form 10-K, which was filed with the United States Securities and Exchange Commission (“SEC”) on March 25, 2025, from which the Company derived the balance sheet data on December 31, 2024.

    The condensed consolidated financial statements include the accounts of the Company and its subsidiaries. Intercompany balances and transactions have been eliminated upon consolidation.

    Use of Estimates

    The preparation of the accompanying unaudited condensed consolidated financial statements in conformity with GAAP requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the unaudited condensed consolidated financial statements and reported amounts of expenses during the reporting period. Actual results could differ from those estimates.

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    On an ongoing basis, management reviews its estimates to ensure that these estimates appropriately reflect changes in the Company’s business and new information as it becomes available. If historical experience and other factors used by management to make these estimates do not reasonably reflect future activity, the Company’s results of operations and financial position could be materially impacted.

    Significant Accounting Policies

    There have been no material changes in the Company’s significant accounting policies to those previously disclosed in the Annual Report on Form 10-K for the year ended December 31, 2024, other than the following:

    Cash Concentration Risk

    The Federal Deposit Insurance Corporation (the “FDIC”) insurance limits are $250,000 per depositor per insured bank. The Company had cash balances of $15.9 million and $1.0 million uninsured by the FDIC as of June 30, 2025 and December 31, 2024, respectively. In August 2023, the Company, through its commercial bank began to utilize the IntraFi network of commercial banks. IntraFi deposits $250,000 in each of its member banks to maintain the FDIC insurance limit. On June 30, 2025, $89.5 million of the Company's cash and cash equivalents was fully FDIC insured.

    Loss Per Share

    Basic loss per share, which excludes antidilutive securities, is computed by dividing net loss by the weighted-average number of common shares outstanding for that particular period. In contrast, diluted loss per share considers the potential dilution that could occur from other equity instruments that would increase the total number of outstanding shares of common stock. Such amounts include shares potentially issuable under outstanding options, restricted stock, and warrants.

    The following outstanding options, restricted stock grants, convertible preferred shares and warrants were excluded from the computation of basic and diluted net loss per share for the periods presented because including them would have had an anti-dilutive effect.

     

     

     

    Six months ended June 30,

     

     

     

    2025

     

     

    2024

     

     

     

     

     

     

     

     

    Warrants to purchase common stock

     

     

    19,740,901

     

     

     

    3,219,694

     

    Options to purchase common stock

     

     

    6,306,747

     

     

     

    1,730

     

    Convertible preferred shares outstanding

     

     

    210

     

     

     

    210

     

    Reclassification of Prior Year Presentation

    Certain prior year amounts have been reclassified. These reclassifications had no effect on the financial position or reported results of operations for the periods presented. In the Condensed Consolidated Statements of Stockholders' Equity for the three months ended March 31, 2024, the presentation of the public offering sale of common stock, warrants, and pre-funded warrants was presented as proceeds, net of offering costs, of $6.2 million in additional paid-in capital and $1.8 million attributed to the exercise of pre-funded warrants. In the current presentation, this is now presented as $8.0 million, net of offering costs of $1.0 million for the public offering of common stock, warrants, and pre-funded warrants and $1 thousand attributed to the exercise of pre-funded warrants.

     

    NOTE 3. ACCRUED LIABILITIES

    Accrued liabilities consist of the following (in thousands):

     

     

     

     

    June 30, 2025

     

     

    December 31, 2024

     

    Operating costs

     

    $

    1,383

     

     

    $

    200

     

    Employee related

     

     

    582

     

     

     

    1,336

     

     

    $

    1,965

     

     

    $

    1,536

     

     

    NOTE 4. COMMITMENTS AND CONTINGENCIES

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    Simdax license agreement

    On November 13, 2013, the Company acquired certain assets of Phyxius Pharma, Inc. (“Phyxius”) pursuant to an asset purchase agreement by and among the Company, Phyxius and the stockholders of Phyxius, dated October 21, 2013. Among these assets was a license with Orion Corporation (“Orion”) for the exclusive, sublicensable right to develop and commercialize pharmaceutical products containing levosimendan, 2.5 mg/ml concentrate for solution for infusion / 5ml vial in the United States and Canada (the “License”). On October 9, 2020 and January 25, 2022, the Company entered into amendments to the License to include in the scope of the License two new oral product formulations containing levosimendan, in capsule and solid dosage form (TNX-103) and a subcutaneously administered dosage form (TNX-102), subject to specified limitations (together, the “Product”).

    On February 19, 2024, the Company entered into an additional amendment to the License providing global rights to oral and subcutaneous formulations of levosimendan used in the treatment of pulmonary hypertension in heart failure with preserved ejection fraction (“PH-HFpEF”). The amendment also reduced the tiered royalties based on worldwide net sales of the product by the Company and its sublicensees, increased the License’s existing milestone payment due to Orion upon the grant of United States Food and Drug Administration approval of a levosimendan-based product to $10.0 million and added a milestone payment to Orion of $5.0 million due upon the grant of regulatory approval for a levosimendan-based product in Japan. The amendment also (i) increased the Company’s obligations to make certain non-refundable commercialization milestone payments to Orion, aggregating to up to $45.0 million, contingent upon achievement of certain cumulative worldwide sales of the product by the Company, and (ii) reduced the maximum price per capsule payable by the Company to Orion, under a yet-to-be-negotiated supply agreement, for the commercial supply of oral levosimendan-based product. Pursuant to the License, the Company and Orion will agree to a new trademark when commercializing levosimendan in either of the dosage forms.

    The term of the License extends until 10 years after the launch of the Product in the territory, provided that the License will continue after the end of the term in each country in the territory until the expiration of Orion’s patent rights in the Product in such country. In the event that no regulatory approval for the Product has been granted in the United States on or before September 20, 2030, however, either party will have the right to terminate the License with immediate effect.

    The License also grants the Company a right of first refusal to commercialize new developments of the Product, including developments as to the formulation, presentation, means of delivery, route of administration, dosage or indication but, pursuant to the February 2024 amendment, excluding new applications of levosimendan for neurological diseases and disorders developed by Orion.

    As of June 30, 2025, the Company has not met any of the developmental milestones under the License and, accordingly, has not recorded any liability for the contingent payments due to Orion.

    Litigation

    The Company is subject to litigation in the normal course of business, none of which management believes will have a material adverse effect on the Company’s consolidated financial statements.

    NOTE 5. STOCKHOLDERS’ EQUITY

    Common Stock and Preferred Stock

    Common Stock

    The Company’s Certificate of Incorporation, as amended, authorizes the issuance of 400,000,000 shares of $0.0001 par value common stock. As of June 30, 2025 and December 31, 2024, there were 4,148,495 and 3,420,906 shares of common stock issued and outstanding, respectively.

    Preferred Stock

    Under the Company’s Certificate of Incorporation, as amended, the Board is authorized, without further stockholder action, to provide for the issuance of up to 10,000,000 shares of preferred stock, par value $0.0001 per share, in one or more series, to establish from time to time the number of shares to be included in each such series, and to fix the designation, powers, preferences and rights of the shares of each such series and the qualifications, limitations and restrictions thereof. Of the potential 10,000,000 shares of preferred stock, 5,181,346 are designated as Series A Stock and 4,818,654 remain undesignated. As of June 30, 2025 and December 31, 2024, there were 210 shares of Series A Stock outstanding, convertible in the aggregate into one share of common stock.

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    Common Stock and Pre-Funded Warrants

    March 2025 Private Placement Financing (the “March 2025 Offering”)

    On March 4, 2025, the Company entered into a securities purchase agreement with certain accredited investors for the purchase and sale, in a private placement financing by the Company, of (i) an aggregate of 378,346 shares of its common stock, and pre-funded warrants to purchase an aggregate of 3,760,726 shares of common stock at an offering price of $6.04 per share of common stock and $6.03 per pre-funded warrant, resulting in gross proceeds of $25.0 million. The pre-funded warrants do not expire and have an exercise price of $0.01. The net proceeds of the March 2025 Offering after deducting placement agent fees and direct offering expenses were $23.2 million. The relative fair value allocated to the common stock and pre-funded warrants was $2.3 million and $22.7 million, respectively.

    Also, on March 5, 2025 and in connection with the March 2025 Offering, the Company entered into a registration rights agreement (the “March 2025 Registration Rights Agreement”) with the purchasers, pursuant to which the Company agreed to register for resale the shares of common stock issued in the March 2025 Offering and the shares of common stock issuable upon exercise of the pre-funded warrants issued in the March 2025 Offering within 45 days of the closing date. Pursuant to the March 2025 Registration Rights Agreement, on April 15, 2025, the Company filed a resale registration statement on Form S-3 with the SEC, which went effective on April 23, 2025.

    The March 2025 Registration Rights Agreement includes liquidated damages provisions that meet the definition of a registration payment arrangement that is within the scope of ASC 825-20. The Company determined at the initial issuance of the pre-funded warrants that it is not probable that a payment would be required as it has both the intent and ability to satisfy the March 2025 Registration Rights Agreement. Therefore, the Company did not record a liability at inception but will evaluate the contingency at each reporting period. As of June 30, 2025, no events had occurred that would change our initial assessment of this provision.

    August 2024 Private Placement Financing (the “August 2024 Offering”)

    On August 6, 2024, the Company entered into a securities purchase agreement with certain accredited investors for the purchase and sale, in a private placement financing by the Company, of (i) an aggregate of 1,450,661 shares of its common stock, and pre-funded warrants to purchase an aggregate of 31,882,671 shares of common stock and (ii) accompanying warrants to purchase up to an aggregate of 16,666,666 shares of its common stock (or, in lieu thereof, additional pre-funded warrants) at a combined offering price of $3.00 per share of common stock and accompanying warrant, or $2.99 per pre-funded warrant and accompanying warrant, resulting in gross proceeds of $99.7 million. The pre-funded warrants do not expire and have an exercise price of $0.01. The net proceeds of the August 2024 Offering after deducting placement agent fees and direct offering expenses were $92.3 million. The relative fair value allocated to the common stock, pre-funded warrants, and accompanying warrants was $3.2 million, $69.4 million, and $27.1 million, respectively.

    Also, on August 6, 2024 and in connection with the August 2024 Offering, the Company entered into a registration rights agreement (the “August 2024 Registration Rights Agreement”) with the purchasers, pursuant to which the Company agreed to register for resale the shares of common stock issued in the August 2024 Offering and the shares of common stock issuable upon exercise of the warrants issued in the August 2024 Offering within 60 days following the effective date of the August 2024 Registration Rights Agreement. Pursuant to the August 2024 Registration Rights Agreement, on August 30, 2024, the Company filed a resale registration statement on Form S-3 with the SEC, which went effective on September 12, 2024.

    The August 2024 Registration Rights Agreement includes liquidated damages provisions that meet the definition of a registration payment arrangement that is within the scope of ASC 825-20. The Company determined at the initial issuance of the pre-funded warrants and accompanying warrant that it is not probable that a payment would be required as it has both the intent and ability to satisfy the August 2024 Registration Rights Agreement. Therefore, the Company did not record a liability at inception but will evaluate the contingency at each reporting period. As of June 30, 2025, no events have occurred that would change our initial assessment of this provision.

    February 2024 Registered Public Offering (the “February 2024 Offering”)

    On February 8, 2024, the Company entered into a securities purchase agreement with certain purchasers for the purchase and sale, in a registered public offering by the Company, of (i) an aggregate of 421,260 shares of its common stock, and pre-funded warrants to purchase an aggregate of 1,178,740 shares of common stock and (ii) accompanying warrants to purchase up to an aggregate of 3,200,000 shares of its common stock at a combined offering price of $5.65 per share of common stock and associated warrant, or $5.649 per pre-funded warrant and accompanying warrant, resulting in gross proceeds of $9.0 million. The net proceeds of the February 2024 Offering after deducting placement agent fees and direct offering expenses were

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    $8.0 million. The relative fair value allocated to the common stock, pre-funded warrants and warrants was $0.9 million, $2.4 million, and $5.7 million, respectively.

    Pre-Funded Warrants Activity

    The following table summarizes the Company’s pre-funded warrant activity for the six months ended June 30, 2025:

     

     

     

    Prefunded Warrants

     

     

    Weighted
    Average
    Exercise Price

     

    Outstanding at December 31, 2024

     

     

    31,882,671

     

     

    $

    0.01

     

    Issued

     

     

    3,760,726

     

     

     

    0.01

     

    Exercised

     

     

    (215,882

    )

     

     

    0.01

     

    Outstanding at June 30, 2025

     

     

    35,427,515

     

     

    $

    0.01

     

    Warrants

    The following table summarizes the Company’s warrant activity for the six months ended June 30, 2025, not including pre-funded warrants:

     

     

     

    Warrants

     

     

    Weighted
    Average
    Exercise Price

     

    Outstanding at December 31, 2024

     

     

    19,874,360

     

     

    $

    5.77

     

    Exercised

     

     

    (133,361

    )

     

     

    4.67

     

    Canceled/Expired

     

     

    (98

    )

     

     

    2,330.24

     

    Outstanding at June 30, 2025

     

     

    19,740,901

     

     

    $

    5.76

     

     

    August 2024 Warrants

    As described above, as part of the August 2024 Offering, the Company issued unregistered warrants to purchase 16,666,666 shares of its common stock at an exercise price of $4.50 per share. The warrants expire at the earlier of (i) 30 trading days following the date of the Company’s initial public announcement of topline data from its Phase 3 LEVEL trial (the “Topline Data Announcement”), (ii) immediately upon the exercise of the August 2024 pre-funded warrants if such exercise is prior to the Topline Data Announcement, provided that if the pre-funded warrant is not exercised in full, the warrant expires proportionally to the extent the pre-funded warrant is exercised, and (iii) August 8, 2029. The warrants have an estimated term of 1.8 years. The unregistered warrants were offered in a private placement under Section 4(a)(2) of the Securities Act of 1933, as amended (the “Securities Act”) and Regulation D promulgated thereunder. In accordance with ASC 815, Derivatives and Hedging, these warrants are classified as equity and their relative fair value of $27.1 million was recognized as additional paid in capital. The estimated fair value is determined using the Black-Scholes option pricing model using the following assumptions: remaining estimated term of 1.8 years, risk free interest rate of 3.83%, expected dividends of zero, and expected volatility of 177.27%.

    February 2024 Warrants

    As described above, as a part of the February 2024 Offering, the Company issued registered warrants to purchase 3,200,000 shares of its common stock at an exercise price of $5.65 per share and contractual term of five years. In accordance with ASC 815, Derivatives and Hedging, these warrants are classified as equity and their relative fair value of $5.7 million was recognized as additional paid in capital. The estimated fair value was determined using the Black-Scholes option pricing model using the following assumptions: remaining estimated term of 5.0 years, risk free interest rate of 4.12%, expected dividends of zero, and expected volatility of 131.87%.

    Stock-Based Compensation

    Stock Incentive Plans

    In June 2022, the Company adopted the 2022 Stock Incentive Plan, as amended on June 7, 2024 and October 25, 2024, (the “2022 Plan”), with the outstanding shares available for future grants under prior plans, as well as outstanding awards under prior

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    plans that subsequently expire, terminate or are surrendered or forfeited, generally being assumed by the 2022 Plan. Unexpired awards granted under certain prior plans may be subject to the terms of such prior plans.

    Under the 2022 Plan, with the approval of the Board’s Compensation Committee, the Company may grant stock options, stock appreciation rights, restricted stock, restricted stock units, performance shares, performance units, cash-based awards or other stock-based awards. Stock options granted under the 2022 Plan may be either incentive stock options (“ISOs”) or nonqualified stock options (“NSOs”). ISOs may be granted only to employees. NSOs may be granted to employees, consultants and directors. Stock options under the 2022 Plan may be granted with a term of up to ten years and at prices no less than fair market value at the time of grant. Stock options granted generally vest over one to four years.

    A total of 2,281,121 shares remained available for issuance under the 2022 Plan as of June 30, 2025.

    Summary of Stock Option Activity

     

    Transactions during the six months ended June 30, 2025 related to stock options granted to employees and directors under Company option plans were as follows:

     

     

     

    Shares

     

     

    Weighted
    average
    exercise
    price per
    Share

     

     

    Weighted
    average
    remaining
    contractual life
    (years)

     

     

    Aggregate
    intrinsic
    value
    (in thousands)

     

    Options outstanding as of December 31, 2024

     

     

    3,126,436

     

     

    $

    6.66

     

     

     

    9.95

     

     

    $

    783

     

    Granted

     

     

    2,930,000

     

     

    5.89

     

     

     

     

     

    Forfeited

     

     

    (3

    )

     

    $

    109,440.00

     

     

     

     

     

     

     

    Options outstanding as of June 30, 2025

     

     

    6,056,433

     

     

    $

    6.24

     

     

     

    9.66

     

     

    $

    2

     

    Options exercisable at June 30, 2025

     

     

    559

     

     

    $

    2,461.98

     

     

     

    8.88

     

     

    $

    1

     

     

    The Company recorded compensation expense for stock options granted under Company stock incentive plans of $4.5 million and $8.5 million for the three and six months ended June 30, 2025, respectively, and $10 thousand and $28 thousand for the three and six months ended June 30, 2024, respectively.

    As of June 30, 2025, there were unrecognized compensation costs of $26.5 million related to non-vested stock option awards that will be recognized on a straight-line basis over the weighted average remaining vesting period of 1.90 years.

    Inducement Stock Options

    The Company granted an employment inducement stock option award for 250,000 shares of common stock to a new employee on January 21, 2025. This employment inducement stock option was awarded in accordance with the employment inducement award exemption provided by Nasdaq Listing Rule 5635(c)(4) and was therefore not awarded under the Company’s stockholder approved equity plan. The option award will vest in four equal annual installments beginning on the first anniversary of the date of issuance, subject to the employee's continued employment with the Company through each applicable vesting date. The option has a 10-year term and an exercise price of $6.45 per share, the January 21, 2025 closing price of the Company’s common stock. The estimated fair value of the inducement stock option award was $1.4 million using the Black-Scholes option pricing model based on market prices and the following assumptions at the date of inducement option grant: risk-free interest rate of 4.49%, dividend yield of 0%, volatility factor for our common stock of 123.41% and an expected life of 6 years.

    The Company granted an employment inducement stock option award for 157 shares of common stock, to its then-new President and Chief Executive Officer on July 6, 2021. The employment inducement stock option award was granted in accordance with the employment inducement award exemption provided by Nasdaq Listing Rule 5635(c)(4) and was therefore not awarded under the Company’s stockholder approved equity plan. This award vests as follows: 25% on the one-year anniversary of the Chief Executive Officer's employment start date and an additional 25% on each of the following three anniversaries of the Chief Executive Officer's employment start date, subject to continued employment. The option has a 10-year term and an exercise price of $3,152 per share, the July 6, 2021 closing price of our common stock. As of June 30, 2025, 75% of the vesting milestones had been achieved. The estimated fair value of this inducement stock option award was $403 thousand using the Black-Scholes option pricing model based on market prices and the following assumptions at the date of inducement option grant: risk-free interest rate of 1.13%, dividend yield of 0%, volatility factor for our common stock of 99.36% and an expected life of 7 years.

    The Company also granted an employment inducement stock option award for 157 shares of common stock to its then-new Chief Medical Officer on January 15, 2021. This employment inducement stock option was awarded in accordance with the

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    employment inducement award exemption provided by Nasdaq Listing Rule 5635(c)(4) and was therefore not awarded under the Company’s stockholder approved equity plan. The option award will vest as follows: 25% upon initiation of a Phase 3 trial; 25% upon database lock; 25% upon acceptance for review of an investigational NDA; and 25% upon approval. The options have a 10-year term and an exercise price of $2,848 per share, the January 15, 2021 closing price of our common stock. As of June 30, 2025, two of the vesting milestones had been achieved. The estimated fair value of the inducement stock option award granted was $403 thousand using the Black-Scholes option pricing model based on market prices and the following assumptions at the date of inducement option grant: risk-free interest rate of 11%, dividend yield of 0%, volatility factor for our common stock of 103.94% and an expected life of 10 years.

    Inducement stock option compensation expense totaled $96 thousand and $237 thousand for the three and six months ended June 30, 2025, respectively, and $13 thousand and $116 thousand for the three and six months ended June 30, 2024, respectively. As of June 30, 2025, there was $1.5 million of remaining unrecognized compensation expense related to these inducement stock options.

    NOTE 6. SEGMENTS

    Operating segments are identified as components of an entity about which separate discrete financial information is available for evaluation by the Chief Operating Decision Maker ("CODM"), or decision-making group, in making decisions on how to allocate resources and assess performance. The Company's CODM, the President and Chief Executive Officer, views the Company's operations as one operating segment, which is focused on identifying and developing therapeutics that address cardiovascular and pulmonary diseases with high unmet medical need, with an initial therapeutic focus on pulmonary hypertension. The Company does not have revenue in the current comparative period, incurs expenses primarily in the United States and manages the business activities on a consolidated basis.

    The accounting policies of the cardiovascular and pulmonary therapeutics segment are the same as those described in the summary of significant accounting policies.

    The CODM assesses performance for the cardiovascular and pulmonary therapeutics segment and decides how to allocate resources based on net loss that also is reported on the income statement as consolidated net loss. The measure of segment assets is reported on the balance sheet as cash and cash equivalents.

    The Company has not generated any product revenue in the current period and expects to continue to incur significant expenses and operating losses for the foreseeable future as the Company advances its product candidates through all stages of development and clinical trials.

    As such, the CODM uses cash forecast models in deciding how to invest into the cardiovascular and pulmonary therapeutics segment. Such cash forecast models are reviewed to assess the entity-wide operating results and performance. Net loss is used to monitor budget versus actual results. Monitoring budgeted versus actual results, net cash used in operating activities for the period and cash on hand are used in assessing performance of the segment.

    The table below summarizes the significant expense categories regularly reviewed by the CODM for the three and six months ended June 30, 2025 and 2024 (in thousands).

     

     

    For the three months ended June 30,

     

     

    For the six months ended June 30,

     

     

    2025

     

     

    2024

     

     

    2025

     

     

    2024

     

    Operating expenses:

     

     

     

     

     

     

     

     

     

     

     

       Research and development

    $

    6,121

     

     

    $

    2,327

     

     

    $

    11,804

     

     

    $

    5,003

     

       General and administrative

     

    5,671

     

     

     

    1,344

     

     

     

    11,326

     

     

     

    2,577

     

    Total operating expenses

    $

    11,792

     

     

    $

    3,671

     

     

    $

    23,130

     

     

    $

    7,580

     

     

     

     

     

     

     

     

     

     

     

     

     

    Net operating loss

     

    (11,792

    )

     

     

    (3,671

    )

     

     

    (23,130

    )

     

     

    (7,580

    )

    Other segment items (a)

     

     

     

     

     

     

     

     

     

     

     

       Interest income

     

    954

     

     

     

    104

     

     

     

    1,884

     

     

     

    222

     

       Interest expense

     

    -

     

     

     

    (9

    )

     

     

    -

     

     

     

    (17

    )

       Other income (expense), net

     

    (9

    )

     

     

    1

     

     

     

    (9

    )

     

     

    1

     

    Net loss (b)

    $

    (10,847

    )

     

    $

    (3,575

    )

     

    $

    (21,255

    )

     

    $

    (7,374

    )

    (a)
    Other segment items included in segment loss includes interest income and interest expense.

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    (b)
    The Company is a single operating segment and therefore the measure of segment net loss is the same as consolidated net loss and does not require reconciliation.

    For the six months ended June 30, 2025 and 2024, the net cash used in operating activities was $13.2 million and $8.2 million, respectively. The table below summarizes the significant asset categories regularly reviewed by the CODM at June 30, 2025 and June 30, 2024 (in thousands).

     

    June 30, 2025

     

     

    June 30, 2024

     

     

    Assets:

     

     

     

     

     

     

    Cash and cash equivalents

    $

    105,462

     

     

    $

    9,384

     

     

     

    NOTE 7. SUBSEQUENT EVENTS

    Subsequent to June 30, 2025, the Company received a total of $0.6 million from the exercise of pre-funded warrants for 271,091 shares of common stock, net due to cashless exercise, and warrants for 142,914 shares of common stock.

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    ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

    The following discussion and analysis should be read in conjunction with the unaudited condensed consolidated financial statements and notes thereto included in Part I, Item 1 of this Quarterly Report on Form 10-Q and with the audited condensed consolidated financial statements and related notes thereto included as part of our Annual Report on Form 10-K for the year ended December 31, 2024. All references in this Quarterly Report to “Tenax Therapeutics,” “we,” “our” and “us” means Tenax Therapeutics, Inc.

    Cautionary Note Regarding Forward-Looking Statements

    This Quarterly Report on Form 10-Q contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, or the Securities Act, and Section 21E of the Securities Exchange Act of 1934, as amended, or the Exchange Act, which are subject to the “safe harbor” created by those sections. Forward-looking statements are based on our management’s beliefs and assumptions and on information currently available to them. In some cases, you can identify forward-looking statements by words such as “might,” “may,” “will,” “should,” “could,” “would,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “projects,” “predicts,” “potential” and similar expressions intended to identify forward-looking statements. These statements reflect our current view with respect to future events and are subject to risks, uncertainties and assumptions related to various factors that could cause actual results and the timing of events to differ materially from future results expressed or implied by such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, those discussed in the section titled “Risk Factors” included in our most recent Annual Report on Form 10-K filed with the SEC. Furthermore, such forward-looking statements speak only as of this Quarterly Report on Form 10-Q. Except as required by law, we undertake no obligation to update any forward-looking statements to reflect events or circumstances after the date of such statements.

    Overview

    Tenax Therapeutics is a clinical-stage pharmaceutical company leveraging clinical insights to develop novel cardiopulmonary therapies. We employ a clinician-driven drug development approach, led by key opinion leaders and advised by thought leaders who are pulmonary hypertension and heart failure experts and informed by their clinical insights to precisely target disease pathophysiology. We are currently actively conducting the LEVEL clinical trial to evaluate levosimendan as our prioritized product candidate, and have deprioritized a Phase 3 clinical trial of imatinib, two drugs supported by promising evidence that they may significantly improve the lives of patients with pulmonary hypertension. Importantly, both levosimendan and imatinib have already been approved in other indications and prescribed around the world for more than 20 years, and we believe their mechanisms of action are uniquely suitable to target and treat pulmonary hypertension. We believe this derisked approach of using already-approved drugs that provide well-established safety profiles from millions of patients, combined with a development path led by preeminent cardiology and pulmonary hypertension experts, puts us in a strong position to deliver breakthrough cardiopulmonary therapies designed to improve patients’ function and quality of life.

    Recent Events

    In March 2025, we closed a private placement financing (the “March 2025 Offering”) raising gross proceeds of approximately $25.0 million. We intend to use the net proceeds from the March 2025 Offering to advance our Phase 3 oral levosimendan program, by completing our ongoing Phase 3 LEVEL study of TNX-103 in pulmonary hypertension resulting from heart failure with preserved ejection fraction (PH-HFpEF) and initiating a second global Phase 3 study, LEVEL-2. We intend to submit marketing authorization applications following completion of the two Phase 3 trials of levosimendan and, when appropriate, a single Phase 3 trial of imatinib.

    Patient enrollment in our Phase 3 LEVEL study continues, with high rates of study and therapy continuation during the blinded and open-label extension stages. We expect to complete enrollment of 230 patients in the first half of 2026. LEVEL is being conducted in Canada and the United States. We remain on track to commence LEVEL-2 this year. The LEVEL-2 trial will have a global footprint.

    Given our resources on June 30, 2025, we believe we can continue our operations through 2027.

    Financial Overview – Three and Six Months Ended June 30, 2025 (in thousands)

     

     

    15


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    For the three months ended June 30,

     

     

    Increase/

     

     

    % Increase/

     

     

     

    For the six months ended June 30,

     

     

    Increase/

     

     

    % Increase/

     

     

     

    2025

     

     

    2024

     

     

    (Decrease)

     

     

    (Decrease)

     

     

     

    2025

     

     

    2024

     

     

    (Decrease)

     

     

    (Decrease)

     

     

    Operating expenses:

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

       Research and development

    $

    6,121

     

     

    $

    2,327

     

     

    $

    3,794

     

     

     

    163

     

     %

     

    $

    11,804

     

     

    $

    5,003

     

     

    $

    6,801

     

     

     

    136

     

     %

       General and administrative

     

    5,671

     

     

     

    1,344

     

     

     

    4,327

     

     

     

    322

     

     %

     

     

    11,326

     

     

     

    2,577

     

     

     

    8,749

     

     

     

    340

     

     %

    Total operating expenses

    $

    11,792

     

     

    $

    3,671

     

     

    $

    8,121

     

     

     

    221

     

     %

     

    $

    23,130

     

     

    $

    7,580

     

     

    $

    15,550

     

     

     

    205

     

     %

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Net operating loss

     

    (11,792

    )

     

     

    (3,671

    )

     

     

    (8,121

    )

     

     

    221

     

     %

     

     

    (23,130

    )

     

     

    (7,580

    )

     

     

    (15,550

    )

     

     

    205

     

     %

    Other segment items

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

       Interest income

     

    954

     

     

     

    104

     

     

     

    850

     

     

     

    817

     

     %

     

     

    1,884

     

     

     

    222

     

     

     

    1,662

     

     

     

    749

     

     %

       Interest expense

     

    -

     

     

     

    (9

    )

     

     

    9

     

     

     

    (100

    )

     %

     

     

    -

     

     

     

    (17

    )

     

     

    17

     

     

     

    (100

    )

     %

      Other income (expense), net

     

    (9

    )

     

     

    1

     

     

     

    (10

    )

     

     

    (1,000

    )

     %

     

     

    (9

    )

     

     

    1

     

     

     

    (10

    )

     

     

    (1,000

    )

     %

    Net loss

    $

    (10,847

    )

     

    $

    (3,575

    )

     

    $

    (7,272

    )

     

     

    203

     

     %

     

    $

    (21,255

    )

     

    $

    (7,374

    )

     

    $

    (13,881

    )

     

     

    188

     

     %

    Research and Development Expenses

    Research and development expenses include, but are not limited to, (i) expenses incurred under agreements with CROs and investigative sites, which conduct a substantial portion of our pre-clinical and clinical studies; (ii) the cost of supplying clinical trial materials; (iii) payments to CROs and consultants; (iv) employee-related expenses, including salaries, non-cash stock compensation expense, and benefits; and (v) facilities, depreciation and other allocated expenses, including direct and allocated expenses for rent and maintenance of facilities and equipment, depreciation of leasehold improvements, equipment, and other supplies. All research and development expenses are expensed as incurred. Research and development expenses and percentage changes for the three and six months ended June 30, 2025 and 2024 are as follows (in thousands):

     

     

     

     

    For the three months ended June 30,

     

     

    Increase/

     

     

    % Increase/

     

     

     

     

    For the six months ended June 30,

     

     

    Increase/

     

     

    % Increase/

     

     

     

     

    2025

     

     

    2024

     

     

    (Decrease)

     

     

    (Decrease)

     

     

     

     

    2025

     

     

    2024

     

     

    (Decrease)

     

     

    (Decrease)

     

     

    Clinical and preclinical development

     

    $

    4,515

     

     

    $

    2,115

     

     

    $

    2,400

     

     

     

    113

     

    %

     

     

    $

    8,788

     

     

    $

    4,517

     

     

    $

    4,271

     

     

     

    95

     

    %

    Salary and benefits

     

     

    468

     

     

     

    192

     

     

     

    276

     

     

     

    144

     

    %

     

     

     

    839

     

     

     

    363

     

     

     

    476

     

     

     

    131

     

    %

    Stock-based compensation

     

     

    982

     

     

     

    2

     

     

     

    980

     

     

     

    49000

     

    %

     

     

     

    1,843

     

     

     

    96

     

     

     

    1,747

     

     

     

    1820

     

    %

    Other costs

     

     

    156

     

     

     

    18

     

     

     

    138

     

     

     

    767

     

    %

     

     

     

    334

     

     

     

    27

     

     

     

    307

     

     

     

    1137

     

    %

     

    Clinical and preclinical development costs increased $2.4 million and $4.3 million for the three and six months ended June 30, 2025, respectively, as compared to the same periods in the prior year. Clinical and preclinical development costs for the three and six months ended June 30, 2025 consists primarily of expenses associated with our ongoing Phase 3 LEVEL trial and our second global Phase 3 study, LEVEL-2, for which we have begun preliminary work, compared with costs for the three and six month periods ended June 30, 2024, associated with the planning of LEVEL and the initiation of the first LEVEL sites and enrollment of the first LEVEL patients.

     

    Salary and benefits costs increased for the three and six months ended June 30, 2025 as compared to the same periods in the prior year primarily due to higher salaries and additional performance-based compensation expense as a result of an increase in the number of employees. Non-cash stock-based compensation expense increased by $1.0 million and $1.7 million for the three and six months ended June 30, 2025, respectively, as compared to the same periods in 2024 primarily due to stock options granted in December 2024, for which the expense is being amortized over a one year vesting period, in addition to new option grants made in January and May 2025 to new and existing employees that vest and are being expensed over four years.

    Other costs increased for the three and six months ended June 30, 2025 as compared to the same periods in the prior year, primarily due to increased regulatory consulting costs as we expanded our ongoing Phase 3 LEVEL trial.

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    General and Administrative Expenses

    General and administrative expenses consist primarily of compensation for executive, finance, legal and administrative personnel, including non-cash stock-based compensation. Other general and administrative expenses include facility costs not otherwise included in research and development expenses, legal and accounting services, and other professional and consulting services. General and administrative expenses and percentage changes for the three and six months ended June 30, 2025 and 2024 are as follows (in thousands):

     

     

     

    For the three months ended June 30,

     

     

    Increase/

     

     

    % Increase/

     

     

     

     

    For the six months ended June 30,

     

     

    Increase/

     

     

    % Increase/

     

     

     

     

    2025

     

     

    2024

     

     

    (Decrease)

     

     

    (Decrease)

     

     

     

     

    2025

     

     

    2024

     

     

    (Decrease)

     

     

    (Decrease)

     

     

    Salary and benefits

     

    $

    673

     

     

    $

    519

     

     

    $

    154

     

     

     

    30

     

    %

     

     

    $

    1,218

     

     

    $

    1,045

     

     

    $

    173

     

     

     

    17

     

    %

    Stock-based compensation

     

     

    3,626

     

     

     

    20

     

     

     

    3,606

     

     

     

    18030

     

    %

     

     

     

    6,907

     

     

     

    45

     

     

     

    6,862

     

     

     

    15249

     

    %

    Legal and professional fees

     

     

    1,050

     

     

     

    614

     

     

     

    436

     

     

     

    71

     

    %

     

     

     

    2,309

     

     

     

    1,050

     

     

     

    1,259

     

     

     

    120

     

    %

    Other costs

     

     

    322

     

     

     

    191

     

     

     

    131

     

     

     

    69

     

    %

     

     

     

    892

     

     

     

    437

     

     

     

    455

     

     

     

    104

     

    %

     

    Salary and benefits increased for the three and six months ended June 30, 2025 as compared to the same periods in 2024 due to increased salaries and related compensation. Non-cash stock-based compensation expense increased $3.6 million and $6.9 million for the three and six months ended June 30, 2025, respectively, as compared to the same periods in 2024 primarily due to stock options granted in December 2024, for which the expense amortizes over a one year vesting term, in addition to new option grants made in May 2025 that vest and are being expensed over four years.

     

    Legal fees consist of the cost of our legal counsel as well as legal costs related to our intellectual property. Professional fees consist of the costs incurred for accounting fees, capital market expenses, consulting fees and investor relations services, as well as fees paid to the members of our Board of Directors. Legal and professional fees increased $0.4 million and $1.3 million for the three and six month periods ended June 30, 2025, respectively, as compared to the same periods in the prior year primarily related to increased capital market expenses, consulting expenses, and accounting expenses.

    Other costs include expenses incurred for franchise and other taxes, travel, supplies, insurance, depreciation, and other miscellaneous charges. Other costs increased $0.1 million and $0.5 million for the three and six months ended June 30, 2025, respectively, as compared to the same periods in the prior year primarily due to increased franchise and other taxes, travel, and insurance related to the growth of the Company.

    Interest Income, Interest Expense, and Other Income (Expense), net

    Interest income increased $1.7 million primarily related to higher interest income on increased cash deposits as a result of the August 2024 Offering and the March 2025 Offering. The company had no interest expense for the six months ended June 30, 2025 and an immaterial amount for the six months ended June 30, 2024.

    Liquidity, Capital Resources and Plan of Operation

    We have incurred losses since our inception and, as of June 30, 2025, we had an accumulated deficit of $336.1 million. We will continue to incur losses until we generate sufficient revenue to offset our expenses, and we anticipate that we will continue to incur net losses for at least the next several years. We expect to incur additional expenses related to our development and potential commercialization of levosimendan and, over the long term, imatinib for PAH, and other potential indications, as well as identifying and developing other potential product candidates, and as a result, we will need to generate significant net product sales, royalty and other revenues to achieve profitability.

    The process of conducting preclinical studies and clinical trials necessary to obtain approval from the United States Food and Drug Administration is costly and time consuming. The probability of success for each product candidate and clinical trial may be affected by a variety of factors, including, among other things, the quality of the product candidate’s early clinical data, investment in the program, competition, manufacturing capabilities and commercial viability. As a result of the uncertainties discussed above, uncertainty associated with clinical trial enrollment and risks inherent in the development process, we are unable to determine the duration and completion costs of current or future clinical stages of our product candidates or when, or to what extent, we will generate revenues from the commercialization and sale of any of our product candidates. Development timelines, probability of success and development costs vary widely. We are currently focused on developing our two product candidates, levosimendan and imatinib, and have prioritized levosimendan; however, we will need substantial additional capital in the future in order to finalize the development of levosimendan, commence its commercialization, potentially develop imatinib, and to continue with the development of other potential product candidates.

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    Liquidity

    We have financed our operations since September 1990 through the issuance of debt and equity securities and loans from stockholders. We had total current assets of $105.9 million and $96.7 million and working capital of $103.3 million and $92.0 million as of June 30, 2025 and December 31, 2024, respectively. Our practice is to invest excess cash, where available, in short-term money market investment instruments and high quality corporate and government bonds.

    We are currently conducting the LEVEL trial and intend to recruit patients concluding in approximately the first half of 2026. Our ability to continue to pursue development of our products, including completion of the second global Phase 3 trial (LEVEL-2), beyond 2027, will depend on obtaining license income, income from warrants exercised by investors should they elect to do so, or outside financial resources. There is no assurance that we will obtain any license agreement or outside financing or that we will otherwise succeed in obtaining any necessary resources.

    Financings

    On March 5, 2025, we sold in the March 2025 Offering an aggregate of 378,346 shares of our common stock and pre-funded warrants to purchase an aggregate of 3,760,726 shares of our common stock at an offering price of $6.04 per share of common stock and $6.03 per pre-funded warrant, resulting in gross proceeds of $25.0 million. The pre-funded warrants do not expire and have an exercise price of $0.01. Net proceeds from the offering were $23.2 million, after deducting the placement agent fees and offering expenses payable by the Company.

    On August 8, 2024, we sold in the August 2024 Offering an aggregate of 1,450,661 shares of our common stock, and pre-funded warrants to purchase 31,882,671 shares of our common stock, along with accompanying warrants to purchase up to 16,666,666 shares of our common stock. The purchase price for each share and accompanying warrant was $3.00, with the accompanying warrant having an exercise price of $4.50 (provided, the purchase price for each pre-funded warrant and accompanying warrant was $2.99, with the pre-funded warrants having an exercise price of $0.01). Net proceeds from the offering were $92.3 million, after deducting the placement agent fees and offering expenses payable by the Company.

    On February 8, 2024, we sold in a registered public offering (the “February 2024 Offering”) (i) an aggregate of 421,260 shares of our common stock and pre-funded warrants to purchase an aggregate of 1,178,740 shares of our common stock and (ii) accompanying warrants to purchase up to an aggregate of 3,200,000 shares of our common stock at a combined offering price of $5.65 per share of common stock and accompanying warrant, or $5.649 per pre-funded warrant and accompanying warrant. Net proceeds of the offering were $8.0 million, after deducting the placement agent fees and offering expenses payable by the Company.

    Cash Flows

    The following table shows a summary of our cash flows for the periods indicated (in thousands):

     

     

     

    Six months ended June 30,

     

     

     

    2025

     

     

    2024

     

    Net cash used in operating activities

     

    $

    (13,230

    )

     

    $

    (8,197

    )

    Net cash provided by investing activities

     

     

    -

     

     

     

    -

     

    Net cash provided by financing activities

     

     

    23,841

     

     

     

    7,789

     

     

    Operating Activities

    Net cash used in operating activities was $13.2 million for the six months ended June 30, 2025, compared to $8.2 million for the six months ended June 30, 2024. The increase in cash used in operating activities was primarily due to increased study expense activity as we expanded our clinical trials and increased payroll costs. The increase in payroll costs was primarily driven by the addition of new employees and targeted salary adjustments, reflecting a necessary investment to support our expanded clinical trial activity during the six months ended June 30, 2025 as compared to the prior year.

    Investing Activities

    There was no net cash provided or consumed by investing activities for the six months ended June 30, 2025 or the six months ended June 30, 2024.

    Financing Activities

    18


    Table of Contents

     

    Net cash provided by financing activities was $23.8 million for the six months ended June 30, 2025, compared to $7.8 million for the six months ended June 30, 2024. The increase during the six months ended June 30, 2025 was due to the $23.2 million net cash provided from the sale of common stock and pre-funded warrants in the March 2025 Offering and $0.6 million from the exercise of warrants and pre-funded warrants as compared to $8.0 million net cash provided from the sale of common stock, pre-funded warrants and warrants in the February 2024 Offering, offset by the principal payment of $0.2 million related to a short-term note, during the six months ended June 30, 2024.

    Operating Capital and Capital Expenditure Requirements

    Our future capital requirements will depend on many factors that include, but are not limited to the following:

    •
    the initiation, design, footprint, progress, timing and completion of clinical trials for our product candidates and potential product candidates;
    •
    the outcome, timing and cost of regulatory approvals and the regulatory approval process;
    •
    delays that may be caused by changing regulatory requirements and resource levels at regulators;
    •
    the number of product candidates we pursue;
    •
    the costs involved in filing and prosecuting patent applications and enforcing and defending patent claims;
    •
    the timing and terms of future collaboration, licensing, consulting or other arrangements that we may enter into;
    •
    the cost and timing of establishing sales, marketing, manufacturing and distribution capabilities;
    •
    the cost of procuring clinical and commercial supplies of our product candidates;
    •
    the extent to which we acquire or invest in businesses, products or technologies; and
    •
    the possible costs of litigation.

    Based on our working capital on June 30, 2025, we believe we have sufficient capital on hand to fund operations through 2027.

    Critical Accounting Policies and Significant Judgments and Estimates

    Our unaudited condensed consolidated financial statements have been prepared in accordance with GAAP. The preparation of these financial statements requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements, as well as the expenses during the reporting periods. These items are monitored and analyzed by us for changes in facts and circumstances, and material changes in these estimates could occur in the future. We base our estimates on historical experience and on various other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Changes in estimates are reflected in reported results for the period in which they become known. Actual results may differ materially from these estimates under different assumptions or conditions. For information regarding our critical accounting policies and estimates, please refer to “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Summary of Critical Accounting Policies” contained in our Annual Report on Form 10-K for the year ended December 31, 2024 and Note 2 to our unaudited condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.

    Off-Balance Sheet Arrangements

    Since our inception, we have not engaged in any off-balance sheet arrangements, including the use of structured finance, special purpose entities or variable interest entities.

    19


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    ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

    Smaller reporting companies are not required to provide the information required by this item.

    ITEM 4. CONTROLS AND PROCEDURES

    Evaluation of Disclosure Controls and Procedures

    As required by paragraph (b) of Rules 13a-15 and 15d-15 promulgated under the Exchange Act, under the supervision and with the participation of our management, including our President and Chief Executive Officer and our Interim Chief Financial Officer, we conducted an evaluation as of the end of the period covered by this Quarterly Report on Form 10-Q, of the effectiveness of our disclosure controls and procedures as defined in Exchange Act Rules 13a-15(e) and 15d-15(e).

    In designing and evaluating our disclosure controls and procedures, management recognizes that any disclosure controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives. In addition, the design of disclosure controls and procedures must reflect the fact that there are resource constraints, and that management is required to apply its judgment in evaluating the benefits of possible controls and procedures relative to their costs.

    Based on their evaluation, our President and Chief Executive Officer and Interim Chief Financial Officer concluded that our disclosure controls and procedures were effective as of June 30, 2025, the end of the period covered by this Quarterly Report on Form 10-Q, in that they provide reasonable assurance that the information we are required to disclose in the reports we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods required by the SEC and is accumulated and communicated to our management, including our President and Chief Executive Officer and Interim Chief Financial Officer, as appropriate to allow timely decisions regarding required disclosure.

    Changes in Internal Control over Financial Reporting

    There were no changes in our internal control over financial reporting during our most recently completed fiscal quarter that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting. We routinely review our internal controls over financial reporting and from time to time make changes intended to enhance the effectiveness of our internal control over financial reporting. We will continue to evaluate the effectiveness of our disclosure controls and procedures and internal controls over financial reporting on an ongoing basis and will take action as appropriate.

    During the most recently completed fiscal quarter, management reviewed all work generated in support of the financial statements and corresponding footnotes to determine areas which may be susceptible to human error. The review focused on limiting manual inputs into work papers wherever possible and tying inputs to external source documents. In addition, management also enhanced its work paper review to compare figures to prior year amounts or source documents and increased the number of calculations in the work papers that are reviewed and re-performed.

    20


    Table of Contents

     

    PART II – OTHER INFORMATION

    ITEM 1. LEGAL PROCEEDINGS

    There are no material pending legal proceedings to which we are a party or to which any of our property is subject.

    ITEM 1A. RISK FACTORS

    The risks we face have not materially changed from those disclosed in our Annual Report on Form 10-K for the year ended December 31, 2024.

    21


    Table of Contents

     

    ITEM 6. EXHIBITS

    The following exhibits are being filed or furnished as part of this Quarterly Report on Form 10-Q and are numbered in accordance with Item 601 of Regulation S-K:

    Exhibit

    Number

    Description

    3.1

     

    Restated Certificate of Incorporation (incorporated by reference to Exhibit 3.2 to the Company’s Form 8-K filed with the SEC on June 17, 2025).

    31.1*

    Certification of President and Chief Executive Officer pursuant to Section 302 of the Sarbanes Oxley Act of 2002.

    31.2*

    Certification of Interim Chief Financial Officer pursuant to Section 302 of the Sarbanes Oxley Act of 2002.

    32.1**

    Certification of President and Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

    32.2**

    Certification of Interim Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

    101*

    Inline XBRL Document Set for the condensed consolidated financial statements and accompanying notes in Part I, Item 1, “Financial Statements” of this Quarterly Report on Form 10-Q.

    104*

    Inline XBRL for the cover page of this Quarterly Report on Form 10-Q, included in the Exhibit 101 Inline XBRL Document Set.

    * Filed herewith

    ** Furnished herewith

    22


    Table of Contents

     

    SIGNATURES

    Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

    Date: August 13, 2025

     

     

    TENAX THERAPEUTICS, INC.

     

     

     

     

     

     

    By:

     /s/ Thomas A. McGauley

     

     

     

    Thomas A. McGauley

     

     

     

    Interim Chief Financial Officer

     

     

     

    (On behalf of the Registrant and as Principal Financial Officer and Accounting Officer)

     

     

    23


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