# EDGAR Filing Document

**Accession Number:** 0000034956
**File Stem:** 0001193125-26-219383
**Filing Date:** 2026-5
**Character Count:** 85133
**Document Hash:** 1f0a1228f6bc565464953dae0e2e20e3
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001193125-26-219383.hdr.sgml**: 20260512

**ACCESSION NUMBER**: 0001193125-26-219383

**CONFORMED SUBMISSION TYPE**: 10-Q

**PUBLIC DOCUMENT COUNT**: 47

**CONFORMED PERIOD OF REPORT**: 20260331

**FILED AS OF DATE**: 20260512

**DATE AS OF CHANGE**: 20260512

**FILER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** TENAX THERAPEUTICS, INC.
- **CENTRAL INDEX KEY:** 0000034956
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **ORGANIZATION NAME:** 03 Life Sciences
- **EIN:** 262593535
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 10-Q
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34600
- **FILM NUMBER:** 26968477

**BUSINESS ADDRESS:**
- **STREET 1:** 101 GLEN LENNOX DRIVE
- **STREET 2:** SUITE 300
- **CITY:** CHAPEL HILL
- **STATE:** NC
- **ZIP:** 27517
- **BUSINESS PHONE:** 919-855-2100

**MAIL ADDRESS:**
- **STREET 1:** 101 GLEN LENNOX DRIVE
- **STREET 2:** SUITE 300
- **CITY:** CHAPEL HILL
- **STATE:** NC
- **ZIP:** 27517

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** OXYGEN BIOTHERAPEUTICS, INC.
- **DATE OF NAME CHANGE:** 20080703

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** SYNTHETIC BLOOD INTERNATIONAL INC
- **DATE OF NAME CHANGE:** 19920703

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** SINEQUANON CORP
- **DATE OF NAME CHANGE:** 19901219

?xml version='1.0' encoding='ASCII'? 10-Q

[**<u>**Table of Contents**</u>**](#toc_page)

**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** **March 31,** 2026

**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**<u>,</u>** Suite 300**<u>,</u>** Chapel Hill**<u>,</u>** North Carolina 27517

**(Address of principal executive offices, including zip code)**

**<u>(</u>**919**<u>)</u>** 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 May 8, 2026, the registrant had outstanding 26,525,159 shares of Common Stock.

------

[**<u>**Table of Contents**</u>**](#toc_page)

**TABLE OF CONTENTS**

---

| | | |
|:---|:---|:---|
|  |  | **PAGE** |
| [**<u>PART I. FINANCIAL INFORMATION</u>**](#part_i_financial_information) | [**<u>PART I. FINANCIAL INFORMATION</u>**](#part_i_financial_information) |  |
| Item 1. | [<u>Financial Statements</u>](#item_1_condensed_consolidated_financial) | 3 |
|  | [<u>Condensed Consolidated Balance Sheets as of March 31, 2026 (Unaudited) and December 31, 2025</u>](#condensed_consolidated_balance_sheets) | 3 |
|  | [<u>Condensed Consolidated Statements of Operations (Unaudited) for the Three Months Ended March 31, 2026 and 2025</u>](#condensed_consolidated_statements_operat) | 4 |
|  | [<u>Condensed Consolidated Statements of Stockholders' Equity (Unaudited) for the Three Ended March 31, 2026 and 2025</u>](#condensed_consolidated_statements_stockh) | 5 |
|  | [<u>Condensed Consolidated Statements of Cash Flows (Unaudited) for the Three Months Ended March 31, 2026 and 2025</u>](#condensed_consolidated_statements_cash) | 6 |
|  | [<u>Notes to Condensed Consolidated Financial Statements (Unaudited)</u>](#notes_to_condensed_consolidated_financi) | 7 |
| Item 2. | [<u>Management's Discussion and Analysis of Financial Condition and Results of Operations</u>](#item_2_managements_discussion_and_analys) | 15 |
| Item 3. | [<u>Quantitative and Qualitative Disclosures About Market Risk</u>](#item_3_quantitative_and_qualitative) | 20 |
| Item 4. | [<u>Controls and Procedures</u>](#item_4_controls_and_procedures) | 20 |
| [**<u>PART II. OTHER INFORMATION</u>**](#part_ii_other_information) | [**<u>PART II. OTHER INFORMATION</u>**](#part_ii_other_information) |  |
| Item 1. | [<u>Legal Proceedings</u>](#item_1_legal_proceedings) | 21 |
| Item 1A. | [<u>Risk Factors</u>](#item_1a_risk_factors) | 21 |
| Item 6. | [<u>Exhibits</u>](#item_6_exhibits) | 22 |
| [**<u>SIGNATURES</u>**](#signatures) | [**<u>SIGNATURES</u>**](#signatures) | 23 |

---

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**PART I - FINANCIAL INFORMATION**

**ITEM 1. FINANCIAL STATEMENTS**

**TENAX THERAPEUTICS, INC.**

**CONDENSED CONSOLIDATED BALANCE SHEETS**

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

---

| | | |
|:---|:---|:---|
|  | **March 31, 2026** | **December 31, 2025** |
|  | **(unaudited)** |  |
| **ASSETS** |  |  |
| Current assets |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash and cash equivalents | $118755 | $97565 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Prepaid expenses | 4316 | 5643 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other current assets | 107 | 1019 |
| &nbsp;&nbsp;&nbsp;&nbsp;Total current assets | 123178 | 104227 |
| Total assets | $123178 | $104227 |
| **LIABILITIES AND STOCKHOLDERS' EQUITY** |  |  |
| Current liabilities |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable | $6346 | $6041 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accrued liabilities | 2140 | 1115 |
| &nbsp;&nbsp;&nbsp;&nbsp;Total current liabilities | 8486 | 7156 |
| Total liabilities | 8486 | 7156 |
| 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 March 31, 2026 and December 31, 2025 | - | - |
| Common stock, par value $0.0001 per share; authorized 400,000,000 shares; issued and outstanding 24,275,500 as of March 31, 2026 and 9,314,130 as of December 31, 2025, respectively | 2 | 1 |
| Additional paid-in capital | 497860 | 464524 |
| Accumulated deficit | (383170) | (367454) |
| Total stockholders' equity | 114692 | 97071 |
| Total liabilities and stockholders' equity | $123178 | $104227 |

---

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

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**TENAX THERAPEUTICS, INC.**

**CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS**

**(unaudited)**

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

---

| | | |
|:---|:---|:---|
|  | **For the three months ended March 31,** | **For the three months ended March 31,** |
|  | **2026** | **2025** |
| Operating expenses |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Research and development | $11539 | $5683 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | 5034 | 5655 |
| &nbsp;&nbsp;&nbsp;&nbsp;Total operating expenses | 16573 | 11338 |
| &nbsp;&nbsp;&nbsp;&nbsp;Net operating loss | (16573) | (11338) |
| Interest income | 861 | 930 |
| Other expense, net | (4) | - |
| Net loss | $(15716) | $(10408) |
| Net loss per share, basic and diluted | $(0.35) | $(0.28) |
| Weighted average number of common shares and prefunded warrants outstanding, basic and diluted | 45226328 | 36584920 |

---

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

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**TENAX THERAPEUTICS, INC.**

**CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY**

**(unaudited)**

**(Amounts in thousands, except share data)**

---

| | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|
|  | **Preferred Stock** | **Preferred Stock** | **Common Stock** | **Common Stock** |  |  |  |
|  | **Number of Shares** | **Amount** | **Number of Shares** | **Amount** | **Additional paid-in capital** | **Accumulated deficit** | **Total stockholders' equity** |
| **Balance at December 31, 2024** | **210** | $**-** | **3420906** | $**-** | $**406848** | $**(314855)** | $**91993** |
| Public offering sale of common stock and prefunded warrants, net of offering costs of $1,746 | - | - | 378346 | - | 23216 | - | 23216 |
| Exercise of pre-funded warrants | - | - | 99189 | - | 1 | - | 1 |
| Exercise of warrants | - | - | 71944 | - | 347 | - | 347 |
| Stock-based compensation expense | - | - | - | - | 4142 | - | 4142 |
| Net loss | - | - | - | - | - | (10408) | (10408) |
| **Balance at March 31, 2025** | **210** | $**-** | **3970385** | $**-** | $**434554** | $**(325263)** | $**109291** |
|  | **Preferred Stock** | **Preferred Stock** | **Common Stock** | **Common Stock** |  |  |  |
|  | **Number of Shares** | **Amount** | **Number of Shares** | **Amount** | **Additional paid-in capital** | **Accumulated deficit** | **Total stockholders' equity** |
| **Balance at December 31, 2025** | **210** | $**-** | **9314130** | $**1** | $**464524** | $**(367454)** | $**97071** |
| Exercise of pre-funded warrants | - | - | 8533958 | 1 | 52 | - | 53 |
| Exercise of warrants | - | - | 6422412 | - | 30416 | - | 30416 |
| Exercise of options |  |  | 5000 | - | 30 | - | 30 |
| Stock-based compensation expense | - | - | - | - | 2838 | - | 2838 |
| Net loss | - | - | - | - | - | (15716) | (15716) |
| **Balance at March 31, 2026** | **210** | $**-** | **24275500** | $**2** | $**497860** | $**(383170)** | $**114692** |

---

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)**

---

| | | |
|:---|:---|:---|
|  | **Three months ended March 31,** | **Three months ended March 31,** |
|  | **2026** | **2025** |
| **CASH FLOWS FROM OPERATING ACTIVITIES** |  |  |
| Net Loss | $(15716) | $(10408) |
| Adjustments to reconcile net loss to net cash used in operating activities |  |  |
| &nbsp;&nbsp;Stock-based compensation | 2838 | 4142 |
| Changes in operating assets and liabilities |  |  |
| &nbsp;&nbsp;Prepaid expenses and other current assets | 2239 | 1224 |
| &nbsp;&nbsp;Accounts payable | 305 | (1318) |
| &nbsp;&nbsp;Accrued liabilities | 1025 | (607) |
| &nbsp;&nbsp;&nbsp;&nbsp;Net cash used in operating activities | (9309) | (6967) |
| **CASH FLOWS FROM FINANCING ACTIVITIES** |  |  |
| Proceeds from issuance of warrants and pre-funded warrants, net of issuance costs | - | 23216 |
| Proceeds from the exercise of options | 30 | - |
| Proceeds from the exercise of warrants and pre-funded warrants | 30469 | 347 |
| &nbsp;&nbsp;&nbsp;&nbsp;Net cash provided by financing activities | 30499 | 23563 |
| Net change in cash and cash equivalents | 21190 | 16596 |
| Cash and cash equivalents, beginning of period | 97565 | 94851 |
| Cash and cash equivalents, end of period | $118755 | $111447 |

---

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 $383.2 million at March 31, 2026 and incurred losses of $15.7 million and $10.4 million during the three months ended March 31, 2026 and 2025, 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 March 31, 2026, the Company had cash and cash equivalents of $118.8 million. Based on its resources on March 31, 2026, 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 generally accepted accounting principles ("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 10, 2026, from which the Company derived the balance sheet data on December 31, 2025.

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 its Annual Report on Form 10-K for the year ended December 31, 2025, 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 $118.5 million and $97.0 million uninsured by the FDIC as of March 31, 2026 and December 31, 2025, respectively.

***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.

---

| | | | | |
|:---|:---|:---|:---|:---|
|  | **Three months ended March 31,** | **Three months ended March 31,** | **Three months ended March 31,** | **Three months ended March 31,** |
|  | **2026** | **2026** | **2025** | **2025** |
| Warrants to purchase common stock |  | 10,472,699 |  | 19,802,318 |
| Options to purchase common stock (stock incentive plans and inducement grants) |  | 8,125,246 |  | 3,376,750 |
| Convertible preferred shares outstanding |  | 210 |  | 210 |

---

**NOTE 3. BALANCE SHEET COMPONENTS**

Prepaid expenses and other current assets consist of the following (in thousands):

---

| | | |
|:---|:---|:---|
|  | **March 31, 2026** | **December 31, 2025** |
| Prepaid assets: |  |  |
| Prepaid CRO expenses | $3717 | $4841 |
| Other prepaid expenses | 599 | 802 |
| Total prepaid expenses | $4316 | $5643 |
| Other current assts: |  |  |
| Cash from warrant exercise held at transfer agent | $- | $949 |
| Miscellaneous other current assets | 107 | 70 |
| Total other current assets | $107 | $1019 |

---

Accrued liabilities consist of the following (in thousands):

---

| | | |
|:---|:---|:---|
|  | **March 31, 2026** | **December 31, 2025** |
| Accrued liabilities: |  |  |
| Accrued CRO expenses | $1387 | $- |
| Operating costs | 263 | 217 |
| Employee related | 490 | 898 |
| Total accrued liabilities | $2140 | $1115 |

---

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**NOTE 4. COMMITMENTS AND CONTINGENCIES**

***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 (as amended from time to time, 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 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 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 (the "FDA") 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.

On September 3, 2025, the Company entered into an amendment to the License providing exclusive worldwide rights to develop, commercialize, manufacture, and have manufactured any orally-administered pharmaceutical product containing levosimendan and, in addition to the Company's existing rights to develop and commercialize subcutaneously administered products containing levosimendan, to manufacture or have manufactured such products. The amendment also calls for Orion to supply the Company with levosimendan to the extent reasonably necessary or useful to manufacture orally-administered products containing levosimendan for purposes of developing such products, and sets forth the terms for such supply, including the price of levosimendan ordered by the Company of low triple-digit thousands in Euros per kilogram, payment terms, and active pharmaceutical ingredient specifications.

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 March 31, 2026, 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*

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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 March 31, 2026 and December 31, 2025, there were 24,275,500 and 9,314,130 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 March 31, 2026 and December 31, 2025, there were 210 shares of Series A Stock outstanding, convertible in the aggregate into one share of common stock.

***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 March 31, 2026, no events had occurred that would change our initial assessment of this provision.

*Pre-Funded Warrants Activity* 

The following table summarizes the Company's pre-funded warrant activity for the three months ended March 31, 2026:

---

| | | |
|:---|:---|:---|
|  | **Prefunded Warrants** | **Weighted<br>Average<br>Exercise Price** |
| **Outstanding at December 31, 2025** | **33102778** | $**0.01** |
| Exercised | (8533958) | 0.01 |
| Canceled/Expired | (2213) | 0.01 |
| **Outstanding at March 31, 2026** | **24566607** | $**0.01** |

---

***Warrants***

The following table summarizes the Company's warrant activity for the three months ended March 31, 2026, not including pre-funded warrants:

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| | | |
|:---|:---|:---|
|  | **Warrants** | **Weighted<br>Average<br>Exercise Price** |
| **Outstanding at December 31, 2025** | **16895111** | $**5.66** |
| Exercised | (6422412) | 4.74 |
| **Outstanding at March 31, 2026** | **10472699** | $**6.23** |

---

*August 2024 Warrants*

As part of the Company's private placement in August 2024 (the "2024 Offering"), the Company issued unregistered common warrants to purchase 16,666,666 shares of its common stock at an exercise price of $4.50 per share (the "August 2024 Warrants") and pre-funded warrants to purchase an aggregate of 31,882,671 shares of common stock. The August 2024 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 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. At March 31, 2026, 10,232,295 of the August 2024 Warrants remained outstanding.

*February 2024 Warrants*

As part of the Company's registered public offering in February 2024, 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. At March 31, 2026, 223,880 of the February 2024 Warrants remained outstanding.

***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 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 ("RSUs"), 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 457,621 shares remained available for issuance under the 2022 Plan as of March 31, 2026.

*Summary of Stock Option Activity*

Transactions during the three months ended March 31, 2026 related to stock options granted to employees and directors under Company option plans were as follows:

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| | | | | |
|:---|:---|:---|:---|:---|
|  | **Shares** | **Weighted<br>average<br>exercise<br>price per<br>Share** | **Weighted<br>average<br>remaining<br>contractual life<br>(years)** | **Aggregate<br>intrinsic<br>value<br>(in thousands)** |
| Options outstanding as of December 31, 2025 | 6616432 | $6.21 | 9.19 | $41382 |
| Granted | 1263500 | 13.27 |  |  |
| Exercised | (5000) | 5.94 |  |  |
| Options outstanding as of March 31, 2026 | 7874932 | $7.34 | 9.04 | $69912 |
| Options exercisable at March 31, 2026 | 3145754 | $6.45 | 8.63 | $31445 |

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The Company estimated the fair value of stock options granted during the three months ended March 31, 2026 using the Black-Scholes option pricing model and the following range of assumptions:

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| | |
|:---|:---|
|  | **For the three months ended March 31, 2026** |
| Risk-free interest rate | 3.50% - 4.04% |
| Expected volatility | 61.03% - 122.17% |
| Expected term (in years) | 1.7 - 7 |
| Expected dividend yield |  |

---

The Company recorded compensation expense for stock options granted under Company stock incentive plans of $2.7 million and $4.0 million and for the three months ended March 31, 2026 and March 31, 2025, respectively.

As of March 31, 2026, 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 2.56 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 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. This award vests as follows: 25% on the one-year anniversary of employment start date and an additional 25% on each of the following three anniversaries of the employment start date, subject to the recipient's continued employment through each applicable vesting date. As of March 31, 2026, 25% of this award had vested. 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. 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. 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. As of March 31, 2026, the option had fully vested. 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 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 has a 10-year term and an exercise price of $2,848 per share, the January 15, 2021 closing price of our common stock. The 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, subject to continued employment through each applicable vesting date. As of March 31, 2026, 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 $0.1 million and $0.1 million for the three months ended March 31, 2026 and March 31, 2025, respectively. As of March 31, 2026, there was $1.0 million of remaining unrecognized compensation expense related to 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

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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 months ended March 31, 2026 and 2025 (in thousands).

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| | | |
|:---|:---|:---|
|  | **For the three months ended March 31,** | **For the three months ended March 31,** |
|  | **2026** | **2025** |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Operating expenses: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Research and development | $11539 | $5683 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | 5034 | 5655 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total operating expenses | $16573 | $11338 |
| &nbsp;&nbsp;&nbsp;&nbsp;Net operating loss | (16573) | (11338) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other segment items (a) |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest income | 861 | 930 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other expense, net | (4) | - |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net loss (b) | $(15716) | $(10408) |

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

(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 three months ended March 31, 2026 and 2025, the net cash used in operating activities was $9.3 million and $7.0 million, respectively. The table below summarizes the significant asset categories regularly reviewed by the CODM at March 31, 2026 and March 31, 2025 (in thousands).

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| | | | | |
|:---|:---|:---|:---|:---|
|  | **March 31,** | **March 31,** | **March 31,** | **March 31,** |
|  | **2026** | **2026** | **2025** | **2025** |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Assets: |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash and cash equivalents |  | 118,755 |  | 111,447 |

---

**NOTE 7. SUBSEQUENT EVENTS**

On April 22, 2026, the Company announced the appointment of Thomas R. Staab, II as Chief Financial Officer of the Company effective May 11, 2026 (the "Start Date"). The Company's current Interim Chief Financial Officer and Principal Financial Officer and Principal Accounting Officer, Thomas A. McGauley, continued as the Company's Principal Financial Officer and Principal Accounting Officer through the filing of this Quarterly Report on Form 10-Q. Under the terms of the Company's existing consulting agreement with Danforth Advisors, LLC, Mr. McGauley will continue to provide consulting services to the Company as Mr. Staab transitions into his new role until at least the end of May 2026. In connection with Mr. Staab's appointment, on May 11, 2026, the Company awarded Mr. Staab inducement awards consisting of (i) 10,000 RSUs and (ii)

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options to purchase 450,000 shares of common stock. The employment inducement awards were made in accordance with the employment inducement award exemption provided by Nasdaq Listing Rule 5635(c)(4) and were therefore not awarded under the Company's stockholder approved equity plan. One quarter of the RSU award will vest 10 days after Mr. Staab's Start Date, with the remainder vesting in three equal installments on the four-month, eight-month, and twelve-month anniversaries of the Start Date. One quarter of the option award will vest on the first anniversary of Mr. Staab's Start Date, with the remainder vesting in 36 approximately equal installments on the monthly anniversaries thereafter. The vesting of both awards is subject to Mr. Staab's continued employment with the Company through each applicable vesting date. The option has a 10-year term and an exercise price equal to the May 11, 2026 closing price of the Company's common stock.

Between April 28, 2026 and June 1, 2026, the Company has awarded or will award inducement option awards as inducements to the employment of four non-executive individuals newly hired by the Company. The employees received or will receive, in the aggregate, non-qualified stock options to purchase 657,500 shares of the Company's common stock with an exercise price equal to the closing price of the Company's common stock as reported by Nasdaq on the start date of each respective employee. The employment inducement awards were made in accordance with the employment inducement award exemption provided by Nasdaq Listing Rule 5635(c)(4) and were therefore not awarded under the Company's stockholder approved equity plan. One quarter of each option award will vest and become exercisable on the first anniversary of the grant date, and the remaining underlying shares will vest in 36 substantially equal installments each month thereafter, subject to the employee's continued service with the Company through each applicable vesting date. Each option award has a 10 year term.

Subsequent to March 31, 2026, the Company received a total of $7.9 million from the exercise of 494,459, net, pre-funded warrants for shares of common stock and 1,755,200 warrants for 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, 2025. All references in this Quarterly Report to "Tenax Therapeutics," "we," "our" and "us" means Tenax Therapeutics, Inc.*

**Cautionary Note Regarding Forward-Looking Statements**

**Overview** 

Tenax Therapeutics is a Phase 3, development-stage pharmaceutical company using clinical insights to develop novel cardiopulmonary therapies. We employ a clinician-driven drug development approach, led by key opinion leaders and heart failure experts and informed by their clinical insights to precisely target disease pathophysiology. We are currently actively conducting the LEVEL and LEVEL-2 clinical trials 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 cardiovascular and pulmonary hypertension experts, puts us in a strong position to deliver breakthrough cardiopulmonary therapies designed to improve patients' functioning and quality of life.

**Recent Events**

In March 2025, we closed a private placement financing raising gross proceeds of approximately $25.0 million. We intend to use the net proceeds from the March 2025 Offering, in addition to approximately $100.0 million raised in August 2024, to advance our Phase 3 oral levosimendan program. Specifically, we plan to complete our ongoing Phase 3 LEVEL study of TNX-103 in PH-HFpEF. We also plan to advance our second global Phase 3 study, LEVEL-2, which commenced in December 2025. Following completion of the two Phase 3 levosimendan trials, we intend to submit marketing authorization applications. We also plan to submit an application for imatinib following completion of a single Phase 3 trial, when appropriate.

Our Phase 3 LEVEL study continues, with high rates of study and therapy continuation during the blinded and open-label extension stages. We achieved our target enrollment of 230 patients in March of 2026. LEVEL is being conducted in the United States and Canada.

Based on our current operating plan, we believe that our existing cash and cash equivalents as of March 31, 2026, along with cash received from warrant exercises subsequent to quarter end, will be sufficient to fund our planned operations through at least the first quarter of 2028.

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***Financial Overview – Three Months Ended March 31, 2026 (in thousands)***

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| | | | | |
|:---|:---|:---|:---|:---|
|  | **For the three months ended March 31,** | **For the three months ended March 31,** | **Increase/** | **% Increase/** |
|  | **2026** | **2025** | **(Decrease)** | **(Decrease)** |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Operating expenses: |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Research and development | $11539 | $5683 | $5856 | 103% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | 5034 | 5655 | (621) | (11)% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total operating expenses | $16573 | $11338 | $5235 | 46% |
| &nbsp;&nbsp;&nbsp;&nbsp;Net operating loss | (16573) | (11338) | (5235) | 46% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other segment items |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest income | 861 | 930 | (69) | (7)% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other expense, net | (4) | - | (4) | 100% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net loss | $(15716) | $(10408) | $(5308) | 51% |

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***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 our clinical studies; (ii) the cost of supplying clinical trial materials; (iii) payments to CROs as well as consultants; (iv) employee-related expenses, which include salaries and benefits; and (v) facilities, depreciation and other allocated expenses, which include 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 months ended March 31, 2026 and 2025 are as follows (in thousands):

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| | | | | |
|:---|:---|:---|:---|:---|
|  | **For the three months ended March 31,** | **For the three months ended March 31,** | **Increase/** | **% Increase/** |
|  | **2026** | **2025** | **(Decrease)** | **(Decrease)** |
| Clinical and preclinical development | $10033 | $4273 | $5760 | 135% |
| Salary and benefits | 891 | 371 | 520 | 140% |
| Stock-based compensation | 537 | 861 | (324) | (38)% |
| Other costs | 78 | 178 | (100) | (56)% |
| Total research and development expense | $11539 | $5683 | 5856 | 103% |

---

Clinical and preclinical development costs increased $5.8 million for the three months ended March 31, 2026, as compared to the same period in the prior year. Clinical and preclinical development costs for the three months ended March 31, 2026 consist primarily of expenses associated with our ongoing Phase 3 LEVEL trial and our second global Phase 3 study, LEVEL-2, which commenced in December 2025, as compared to the three months ended March 31, 2025, which consisted primarily of costs associated with our Phase 3 LEVEL trial.

Salary and benefits costs increased by $0.5 million for the three months ended March 31, 2026 as compared to the same period 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 decreased by $0.3 million for the three months ended March 31, 2026, as compared to the same period in 2025 primarily due to stock options granted in December 2024, for which the expense was recognized over a one year vesting period and became fully vested in December 2025, partially offset by new option grants made in 2026 to employees that vest and are being expensed over four years.

Other costs decreased for the three months ended March 31, 2026 as compared to the same period in the prior year, primarily due to increased regulatory consulting costs as we continued to expand our Phase 3 trials.

***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 months ended March 31, 2026 and 2025 are as follows (in thousands):

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| | | | | |
|:---|:---|:---|:---|:---|
|  | **For the three months ended March 31,** | **For the three months ended March 31,** | **Increase/** | **% Increase/** |
|  | **2026** | **2025** | **(Decrease)** | **(Decrease)** |
| Salary and benefits | $839 | $545 | $294 | 54% |
| Stock-based compensation | 2301 | 3281 | (980) | (30)% |
| Legal and professional fees | 1366 | 1259 | 107 | 8% |
| Other costs | 528 | 570 | (42) | (7)% |
| Total general and administrative expense | $5034 | $5655 | (621) | (11)% |

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Salary and benefits increased $0.3 million for the three months ended March 31, 2026, compared to the same period in 2025. The change was primarily attributable to increased head count and salaries, and related compensation.

Non-cash stock-based compensation expense decreased $1.0 million for the three months ended March 31, 2026, as compared to the same period in 2025 primarily due to stock options granted in December 2024, for which the expense was amortized over a one-year vesting term, which was partially offset by new option grants made in 2026.

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 $0.1 million for the three month period ended March 31, 2026, as compared to the same period in the prior year.

Other costs include expenses incurred for franchise and other taxes, travel, supplies, insurance, depreciation, and other miscellaneous charges.

***Interest Income, Interest Expense, and Other Expense, net***

Interest income decreased by $0.1 million for the three months ended March 31, 2026, as compared to the same period in the prior year primarily due to lower interest rates. The Company had an immaterial other expense for the three months ended March 31, 2026 and none for the comparable period in the prior year.

**Liquidity, Capital Resources and Plan of Operation**

We have incurred losses since our inception and, as of March 31, 2026, we had an accumulated deficit of $383.2 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 FDA 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.

*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 $123.2 million and $104.2 million and working capital of $114.7 million and $97.1 million as of March 31, 2026 and December 31, 2025, 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 into the first half of 2026. We commenced our LEVEL-2 trial in December 2025 and are currently enrolling patients. Our ability to continue to pursue development of our products beyond March of 2028, including completion of a second Phase 3 oral levosimendan trial, will depend on obtaining license income, income from warrants exercised by investors should they elect to do so, or other financial resources. There is

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no assurance that we will obtain any license agreement or other 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 March 24, 2026, we filed a universal shelf registration statement on Form S-3 with the SEC, which the SEC declared effective on April 1, 2026. Pursuant to this registration statement, we have the ability to sell up to $300.0 million of any combination of our equity or debt securities in one or more public offerings, at prices and on terms that we will determine at the time of offering.

*Cash Flows*

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

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| | | |
|:---|:---|:---|
|  | **Three months ended March 31,** | **Three months ended March 31,** |
|  | **2026** | **2025** |
| &nbsp;&nbsp;Net cash used in operating activities | $(9309) | $(6967) |
| &nbsp;&nbsp;Net cash provided by investing activities | - | - |
| &nbsp;&nbsp;Net cash provided by financing activities | 30499 | 23563 |

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*Operating Activities*

Net cash used in operating activities was $9.3 million for the three months ended March 31, 2026, compared to $7.0 million for the three months ended March 31, 2025. The increase in cash used in operating activities was primarily due to increased expenses 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 three months ended March 31, 2026 as compared to the prior year period.

*Investing Activities*

There was no net cash provided or consumed by investing activities for the three months ended March 31, 2026 or the three months ended March 31, 2025.

*Financing Activities*

Net cash provided by financing activities was $30.5 million for the three months ended March 31, 2026, compared to $23.6 million for the three months ended March 31, 2025, an increase of $6.9 million. During the three months ended March 31, 2026, the Company received proceeds of $30.5 million from the exercise of warrants and pre-funded warrants. During the three months ended March 31, 2025, the Company received proceeds of $23.2 million net cash provided from the sale of common stock and pre-funded warrants in the March 2025 Offering and $0.3 million from the exercise of warrants and pre-funded warrants.

***Operating Capital and Capital Expenditure Requirements***

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

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the initiation, design, footprint, progress, timing and completion of clinical trials for our product candidates and potential product candidates;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the outcome, timing and cost of regulatory approvals and the regulatory approval process;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•delays that may be caused by changing regulatory requirements and resource levels at regulators;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the number of product candidates we pursue;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the costs involved in filing and prosecuting patent applications and enforcing and defending patent claims;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the timing and terms of future collaboration, licensing, consulting or other arrangements that we may enter into;

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the cost and timing of establishing sales, marketing, manufacturing and distribution capabilities;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the cost of procuring clinical and commercial supplies of our product candidates;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the extent to which we acquire or invest in businesses, products or technologies; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;•the possible costs of litigation.

Based on our working capital on March 31, 2026, and additional cash received subsequent to quarter end of $7.9 million, we believe we have sufficient capital on hand to fund operations through at least the first quarter of 2028.

***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, 2025 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.

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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 (Principal Executive Officer) and our Principal Financial Officer and Principal Accounting 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 (Principal Executive Officer) and our Principal Financial Officer and Principal Accounting Officer, concluded that our disclosure controls and procedures were effective as of March 31, 2026, 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 (Principal Executive Officer) and our Principal Financial Officer and Principal Accounting 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.

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**PART II – OTHER INFOR** **MATION**

**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, 2025.

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**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**<br>**Number** | **Description** |
| [<u>10.1+</u>](https://www.sec.gov/Archives/edgar/data/34956/000165495426000232/tennx_ex101.htm) | [<u>Second Amendment to Executive Employment Agreement by and between Tenax Therapeutics, Inc. and Stuart Rich, MD, dated January 6, 2026 (incorporated by reference to Exhibit 10.1 to the Company's Form 8-K filed with the SEC on January 9, 2026).</u>](https://www.sec.gov/Archives/edgar/data/34956/000165495426000232/tennx_ex101.htm) |
| [<u>10.2+</u>](https://www.sec.gov/Archives/edgar/data/34956/000119312526168521/d81080dex101.htm) | [<u>Executive Employment Agreement with Thomas R. Staab, II, dated April 9, 2026 (incorporated by reference to Exhibit 10.1 to the Company's Form 8-K filed with the SEC on April 22, 2026).</u>](https://www.sec.gov/Archives/edgar/data/34956/000119312526168521/d81080dex101.htm) |
| [<u>10.3+</u>](https://www.sec.gov/Archives/edgar/data/34956/000119312526168521/d81080dex102.htm) | [<u>Form of Inducement Restricted Stock Unit Award Agreement (incorporated by reference to Exhibit 10.2 to the Company's Form 8-K filed with the SEC on April 22, 2026).</u>](https://www.sec.gov/Archives/edgar/data/34956/000119312526168521/d81080dex102.htm) |
| [<u>31.1\*</u>](tennx-ex31_1.htm) | [<u>Certification of President and Chief Executive Officer pursuant to Section 302 of the Sarbanes Oxley Act of 2002.</u>](tennx-ex31_1.htm) |
| [<u>31.2\*</u>](tennx-ex31_2.htm) | [<u>Certification of Principal Financial Officer and Principal Accounting Officer pursuant to Section 302 of the Sarbanes Oxley Act of 2002.</u>](tennx-ex31_2.htm) |
| [<u>32.1\*\*</u>](tennx-ex32_1.htm) | [<u>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.</u>](tennx-ex32_1.htm) |
| [<u>32.2\*\*</u>](tennx-ex32_2.htm) | [<u>Certification of Principal Financial Officer and Principal Accounting Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.</u>](tennx-ex32_2.htm) |
| 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. |

---

+ Management contract or compensatory plan.

\* Filed herewith

\*\* Furnished herewith

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**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: May 12, 2026

---

| | |
|:---|:---|
| **TENAX THERAPEUTICS, INC.** | **TENAX THERAPEUTICS, INC.** |
| By: | /s/ Christopher T. Giordano |
|  | Christopher T. Giordano |
|  | President and Chief Executive Officer |
| By: | /s/ Thomas A. McGauley |
|  | Thomas A. McGauley |
|  | Principal Financial Officer and Principal Accounting Officer |

---

------

## Exhibit 31.1

**EXHIBIT 31.1**

**CERTIFICATION PURSUANT TO** 

**SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002**

I, Christopher T. Giordano, certify that:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.I have reviewed this Quarterly Report on Form 10-Q of Tenax Therapeutics, Inc.;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4.The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a)designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b)designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;c)evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;d)disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5.The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a)all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b)any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

---

| | |
|:---|:---|
| Date: May 12, 2026 |  |
|  | /s/ Christopher T. Giordano |
|  | Christopher T. Giordano |
|  | *President and Chief Executive Officer*<br>*(Principal Executive Officer)* |

---

------

## Exhibit 31.2

**EXHIBIT 31.2**

**CERTIFICATION PURSUANT TO** 

**SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002**

I, Thomas A. McGauley, certify that:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.I have reviewed this Quarterly Report on Form 10-Q of Tenax Therapeutics, Inc.;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4.The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a)designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b)designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;c)evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;d)disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5.The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a)all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b)any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

---

| | |
|:---|:---|
| Date: May 12, 2026 |  |
|  | /s/ Thomas A. McGauley |
|  | Thomas A. McGauley |
|  | *Principal Financial Officer and* <br>*Principal Accounting Officer* |

---

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## Exhibit 32.1

**EXHIBIT 32.1**

**CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002**

In connection with the Quarterly Report of Tenax Therapeutics, Inc. (the "Company") on Form 10-Q for the period ended March 31, 2026 as filed with the Securities and Exchange Commission on the date hereof (the "Report"), I, Christopher T. Giordano, President and Chief Executive Officer (Principal Executive Officer) of the Company, certify pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that, to my knowledge:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods covered by the Report.

Date: May 12, 2026

---

| |
|:---|
| /s/ Christopher T. Giordano |
| Christopher T. Giordano |
| *President and Chief Executive Officer*<br>*(Principal Executive Officer)* |

---

The foregoing certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, and is not being filed for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and is not to be incorporated by reference into any filing of the Company, whether made before or after the date hereof, regardless of any general incorporation language in such filing.

A signed original of this written statement required by Section 906 of the Sarbanes-Oxley Act of 2002 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.

------

## Exhibit 32.2

**EXHIBIT 32.2**

**CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002**

In connection with the Quarterly Report of Tenax Therapeutics, Inc. (the "Company") on Form 10-Q for the period ended March 31, 2026 as filed with the Securities and Exchange Commission on the date hereof (the "Report"), I, Thomas A. McGauley, Principal Financial Officer and Principal Accounting Officer of the Company, certify pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that, to my knowledge:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods covered by the Report.

Date: May 12, 2026

---

| |
|:---|
| /s/ Thomas A. McGauley |
| Thomas A. McGauley |
| *Principal Financial Officer and* <br>*Principal Accounting Officer* |

---

The foregoing certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. Section 1350 , as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, and is not being filed for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and is not to be incorporated by reference into any filing of the Company, whether made before or after the date hereof, regardless of any general incorporation language in such filing.

A signed original of this written statement required by Section 906 of the Sarbanes-Oxley Act of 2002 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.

------