Document:

Note issued to Arcion Therapetuics, Inc., dated May 18, 2009

 Exhibit 10.91 
 THIS NOTE HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ACT”). NO SALE, PLEDGE OR DISPOSITION MAY BE EFFECTED EXCEPT IN COMPLIANCE WITH RULE 144 UNDER SAID ACT OR AN EFFECTIVE REGISTRATION STATEMENT
RELATED THERETO OR AN OPINION OF COUNSEL FOR THE HOLDER, REASONABLY SATISFACTORY TO THE COMPANY, THAT SUCH REGISTRATION IS NOT REQUIRED UNDER THE ACT. 
 THIS NOTE IS SUBJECT TO THE TERMS AND CONDITIONS OF THE PURCHASE AGREEMENT (AS DEFINED BELOW). 
 NOTE 
  

			
	 $2,000,000.00
	  	May 18, 2009

 For value received, Anesiva, Inc., a Delaware corporation (the “Company”),
promises to pay to the order of Arcion Therapeutics, Inc. (together with its successors and assigns, the “Holder”), the principal sum of Two Million Dollars ($2,000,000), together with interest accrued but unpaid thereon, upon the
terms of this Note (the “Note”). 
 Interest shall accrue from the date hereof until maturity at a continuously compounding
rate equal to ten percent (10%) per annum payable in cash; provided, however, that, during the occurrence and continuance of an Event of Default (as defined in that certain Secured Note Purchase Agreement, dated as of May 18,
2009 (as amended, restated, supplemented or otherwise modified from time to time, the “Purchase Agreement”), among the Company and the Holder), interest shall accrue at a continuously compounding rate equal to fourteen percent
(14%) per annum. All computations of interest shall be made on the basis of a year of 365 or 366 days, as the case may be, for the actual number of days (including the first day but excluding the last) occurring in the period for which such
interest is payable. 
 Unless earlier paid pursuant to the terms hereof or the Purchase Agreement or accelerated in connection with an Event
of Default, subject to the terms of the Purchase Agreement, the outstanding principal and accrued but unpaid interest shall be immediately due and payable on October 20, 2009 (the “Maturity Date”). Company may prepay this Note
at any time without penalty or premium. 
 1. This Note is issued pursuant to the terms of the Purchase Agreement. The Holder is entitled to
the benefit of, and is subject to certain restrictions contained in, the Purchase Agreement and the other Related Documents. Capitalized terms not otherwise defined herein shall have the meanings ascribed to them in the Purchase Agreement. The
indebtedness evidenced by this Note is secured by certain collateral, as more particularly described in that certain Pledge, Security and Collateral Agent Agreement, dated as of May 18, 2009 (as may be further amended, restated, supplemented or
modified from time to time, the “Security Agreement”), among the Company, AlgoRx Pharmaceuticals, Inc. and the Collateral Agent and that certain Guaranty, dated as of January 20, 2009 (as may be further amended or modified from
time to time, the “Guaranty”) by and between AlgoRx Pharmaceuticals, Inc. and the Holder. 

 
Each holder of this Note will be deemed, by its acceptance hereof, to have agreed to the provisions and to have made the representations and warranties set
forth in Section 4 the Purchase Agreement. Subject to the terms of the Purchase Agreement, this Note is transferable by surrender hereof at the principal office of the Company, duly endorsed or accompanied by a written instrument of transfer
duly executed by the registered holder of this Note or by any other method permitted by the Purchase Agreement. 
 2. All payments hereunder
shall be applied in the order provided for in the Purchase Agreement. Whenever any payment hereunder shall be stated to be due, or whenever any return payment date or any other date specified hereunder would otherwise occur, on a day other than a
Business Day, then such payment shall be made, and such return payment date or other date shall occur, on the next succeeding Business Day, and such extension of time shall in such case be included in the computation of payment of interest
hereunder. 
 3. All payments in respect of this Note shall be in immediately available lawful money of the United States of America and
shall be sent so as to be received no later than 2 p.m. (Pacific time) on the date of payment, at the address specified in the Purchase Agreement, or at such other address as may be specified from time to time by such Holder in a written notice
delivered to the Company. All payments in respect of this Note shall be made unconditionally in full without any deduction, set off, counterclaim or other defense. If any scheduled payment date is not a Business Day, such payment shall be made on
the next succeeding Business Day. 
 4. The Company hereby waives demand, notice, presentment, protest and notice of dishonor. 
 5. (a) The terms of this Note shall be construed in accordance with the laws of the State of California, as applied to contracts entered into by
California residents within the State of California, which contracts are to be performed entirely within the State of California. The Company hereby (i) submits to the exclusive jurisdiction of the courts of the County of San Francisco, State
of California and the Federal courts of the United States sitting in the Northern District of the State of California for the purpose of any action or proceeding arising out of or relating to this Note, the Purchase Agreement and the Related
Documents; (ii) agrees that all claims in respect of any such action or proceeding may be heard and determined in such courts; (iii) irrevocably waives (to the extent permitted by applicable law) any objection that it now or hereafter may
have to the laying of venue of any such action or proceeding brought in any of the foregoing courts, and any objection on the ground that any such action or proceeding in any such court has been brought in an inconvenient forum; and (iv) agrees
that a final judgment in any such action or proceeding shall be conclusive and may be enforced in other jurisdictions by suit on the judgment or in any other manner permitted by law. 
 (b) The parties agree that any dispute, controversy or claim (including any counterclaim) (each, a “Dispute”) arising out
of or relating to this Note, the Purchase Agreement or any Related Documents shall be finally resolved by confidential binding arbitration in San Francisco County, California as the sole and exclusive method of resolving such dispute, controversy or
claim. Any Dispute shall be settled by arbitration under the rules then in effect of JAMS/Endispute conducted by a single arbitrator reasonably acceptable to the parties. The arbitrator shall have no power to amend this Note, the Purchase Agreement
or any Related 

  

 2 

 
Documents. The arbitrator shall issue an award in writing (including an explanation of the grounds for such award) as promptly as practicable that shall be
final and binding on the parties. Judgment upon any award thus obtained may be entered in any court having jurisdiction thereof. No action at law or in equity based upon any claim arising out of or related to this Note, the Purchase Agreement or any
Related Documents shall be instituted in any court by any party except (a) an action to compel arbitration pursuant to this Section 5(b); or (b) an action to enforce an award obtained in an arbitration proceeding in accordance with
this Section 5(b). Pending the submission to arbitration and thereafter until the arbitrator publishes its award, each party shall, except in the event of termination, continue to perform all its obligations under this Note, the Purchase
Agreement and the Related Documents without prejudice to a final adjustment in accordance with the award. 
 6. Notwithstanding any provision
of this Note to the contrary, any payments hereunder deemed to be interest shall not exceed the maximum rate permitted by applicable law. To the extent that any interest otherwise paid or payable by the Company to the Holder shall have been finally
adjudicated to exceed the maximum amount permitted by applicable law, such interest shall be retroactively deemed to have been a required repayment of principal (and any such amount paid in excess of the outstanding principal amount shall be
promptly returned to the Company). 
 7. Any term of this Note and the other Securities may be amended and the observance of any term of this
Note and the other Securities may be waived (either generally or in a particular instance and either retroactively or prospectively), only in accordance with the terms of the Purchase Agreement. Any such amendment or waiver shall be effective only
for the specific instance and for the specific purpose for which given. 
 8. No remedy herein conferred upon the Holder is intended to be
exclusive of any other remedy, and each and every such remedy shall be cumulative and shall be in addition to every right or other remedy now or hereafter existing at law or in equity or by statute or otherwise. 
 9. No course of dealing between the Company and the Holder or any delay on the part of the Holder in exercising any rights or remedies shall operate as a
waiver of any such right or remedy of the Holder. 
 10. This Note shall be binding on and inure to the benefit of and be enforceable by the
Company, the Holder and their respective successors and assigns. The Company may not assign, transfer, hypothecate or otherwise convey its rights, benefits, obligations or duties hereunder without the prior express written consent of the Majority
Investors. Any such purported assignment, transfer, hypothecation or other conveyance by the Company without the prior express written consent of the Majority Investors shall be void. 
 11. Whenever possible, each provision of this Note shall be interpreted in such manner as to be effective and valid under all applicable laws and
regulations. If, however, any provision of this Note shall be prohibited by or invalid under any such law or regulation in any jurisdiction, it shall, as to such jurisdiction, be deemed modified to conform to the minimum requirements of such law or
regulation, or, if for any reason it is not deemed so modified, it shall be ineffective and invalid only to the extent of such prohibition or invalidity without affecting the remaining provisions of this Note, or the validity or effectiveness of
such provision in any other jurisdiction. 
  

 3 

 12. This Note is issued pursuant to the Purchase Agreement and in connection with the Security Agreement,
the Pledge Agreement and the other Related Documents. Material terms applicable to this Note are set forth in the Purchase Agreement, the Security Agreement, the Pledge Agreement and the other Related Documents. This Note shall be interpreted in a
manner to give full effect to its provisions and the provisions of the Purchase Agreement, the Security Agreement, the Pledge Agreement and the other Related Documents. 
 13. The Company agrees to pay on demand all costs and expenses of the Holder, and the reasonable fees and disbursements of its counsel (including the allocated costs of internal counsel), in connection with:
(i) any amendments, modifications or waivers of the terms hereof or of the Purchase Agreement or of any other Related Documents; (ii) the protection or preservation of the Holder’s rights under this Note, under the Purchase Agreement
or under any other Related Documents, whether by judicial proceeding or otherwise; (iii) enforcement or attempted enforcement of, and preservation of any rights under, this Note, the Purchase Agreement or any other Related Documents;
(iv) creating, maintaining and perfecting Liens in favor of the Collateral Agent, for the benefit of the Holder, including filing and recording fees and expenses, and (v) any out-of-court workout or other refinancing or restructuring or in
any bankruptcy case, including, without limitation, any and all losses, costs and expenses sustained by the Holder as a result of any failure by the Company to perform or observe its obligations contained herein or in the Purchase Agreement or in
any of the other Related Documents. 
 [Remainder of page intentionally left blank] 
  

 4 

 This Note has been issued in reliance upon the representations and warranties and covenants and
agreements of the Company and the Holder set forth in the Purchase Agreement. 
  

			
	ANESIVA, INC.
		
	By:	 	/s/ Michael L. Kranda
	Name:	 	Michael L. Kranda
	Title:	 	President and CEO

  

			
	Accepted and Agreed:
	
	ARCION THERAPEUTICS, INC.
		
	By:	 	/s/ James N. Campbell, M.D
	Name:	 	James N. Campbell, M.D.
	Title:	 	Chief Executive Officer

 [SIGNATURE PAGE TO SECURITY]Subordination Agreement, dated May 18, 2009

 Exhibit 10.92 
 SUBORDINATION AGREEMENT 
 This Subordination Agreement is made as of May 18, 2009 by and among each of
the undersigned creditors (individually, a “Creditor” and, collectively, the “Creditors”), Arcion Therapeutics, Inc. (“Senior Lender”), Anesiva, Inc., a Delaware corporation
(“Borrower”) and AlgoRx Pharmaceuticals, Inc., a Delaware corporation (the “Guarantor” and, together with the Borrower, the “Loan Parties”). 
 Recitals 
 A. The Borrower has obtained certain loans or other credit
accommodations from Senior Lender pursuant to that certain Secured Note Purchase Agreement, dated as of May 18, 2009, between the Borrower and the Senior Lender (as it may hereafter be amended, supplemented or otherwise modified from time to
time, the “Senior Note”) that are secured by substantially all of the assets of the Loan Parties pursuant to that certain Pledge, Security and Collateral Agent Agreement, dated as of May 18, 2009 (as it may be amended,
restated, supplemented or otherwise modified from time to time, the “Senior Security Agreement”). 
 B. Each Creditor has
extended loans or other credit accommodations to Borrower, and/or may extend loans or other credit accommodations to Borrower from time to time that are secured by substantially all of the assets of the Loan Parties pursuant to that certain Pledge,
Security and Collateral Agent Agreement, dated as of January 20, 2009 (as it may be amended, restated, supplemented or otherwise modified from time to time, the “Subordinated Security Agreement”). 
 C. In order to induce Senior Lender to extend credit to Borrower, each Creditor is willing to subordinate: (i) all of the Loan Parties’
indebtedness and obligations to such Creditor, whether presently existing or arising in the future (the “Subordinated Debt”), to the prior indefeasible payment in full in cash all of all obligations of the Loan Parties in respect of
principal, interest, fees, costs, expenses (including, without limitation, legal fees and expenses of counsel and allocated costs of internal counsel), indemnities and liabilities of whatsoever nature now or hereafter made, incurred or created,
whether absolute or contingent, liquidated or unliquidated, whether due or not due, and however arising under or in connection with the Senior Note or the Related Documents (as defined in the Senior Note), together with all costs of collecting such
obligations (including attorneys’ fees), including, without limitation, all interest accruing after the commencement by or against any Loan Party of any bankruptcy, insolvency, reorganization or similar proceeding, or any out of court
restructuring (the “Senior Debt”); and (ii) all of such Creditor’s security interests, if any, in any Loan Party’s property, to all of Senior Lender’s security interests in such Loan Party’s property. All
notes, guarantees, documents, agreements and instruments now existing or hereinafter entered into evidencing or pertaining to all or any portion of the Senior Debt, as the same may be amended, extended, restated, supplemented or otherwise modified
from time to time shall be referred to herein, as the “Senior Debt Documents”. All notes, guarantees, documents, agreements and instruments now existing or hereinafter entered into evidencing or pertaining to all or any portion of
the Subordinated Debt, including the Security Purchase Agreement, dated as of January 20, 2009 (the “Subordinated Purchase Agreement”), as the same may be amended, extended, restated, supplemented or otherwise modified from
time to time in compliance with this Agreement shall be referred to herein, as the “Subordinated Debt Documents”. 
 NOW,
THEREFORE, THE PARTIES AGREE AS FOLLOWS: 
 1. Notwithstanding anything to the contrary in the Subordinated Security Agreement or any other
Subordinated Debt Document, each Creditor subordinates to Senior Lender any security interest or lien that such Creditor may have in any property of any Loan Party. Notwithstanding the respective dates of attachment or perfection of the security
interest of a Creditor and the security interest of Senior Lender, the security interest of Senior Lender in the Collateral (as defined in the Senior Security Agreement), shall at all times be prior to the security interest of such Creditor.
Capitalized terms not otherwise defined herein shall have the same meaning as in the Senior Note or the Senior Security Agreement, as applicable. 

 2. Notwithstanding anything to the contrary in the Subordinated Security Agreement or any other
Subordinated Debt Document, all Subordinated Debt is subordinated in right of payment to the prior indefeasible payment in full in cash of all Senior Debt. 
 3. Each Creditor will not demand or receive from any Loan Party (and no Loan Party will pay to such Creditor) all or any part of the Subordinated Debt, by way of payment, prepayment, setoff, lawsuit or
otherwise, nor will such Creditor exercise any right or remedy (by law or pursuant to any Subordinated Debt Document) with respect to the Collateral, nor will such Creditor commence, or cause to commence, prosecute or participate in any
administrative, legal or equitable action against any Loan Party, for so long as any portion of the Senior Debt remains outstanding. Notwithstanding the foregoing, (i) each Creditor shall be entitled to receive each regularly scheduled
payment of interest under those certain promissory notes issued by Borrower pursuant to the Purchase Agreement to the order of Creditor presented to Senior Lender as of the date hereof, provided that no Default or Event of Default (as defined in the
Senior Note) has occurred and is continuing or would exist immediately after giving effect to such payment and (ii) nothing in this Agreement shall restrict the conversion of any Subordinated Debt into equity securities of Borrower in
accordance with the terms of any instruments evidencing the Subordinated Debt. 
 4. Each Creditor shall promptly deliver to Senior
Lender in the form received (except for endorsement or assignment by such Creditor where required by Senior Lender) for application to the Senior Debt any payment, distribution, security or proceeds received by such Creditor with respect to the
Subordinated Debt other than in accordance with this Agreement. 
 5. In the event of a Loan Party’s insolvency, reorganization or any
case or proceeding under any bankruptcy or insolvency law or laws relating to the relief of debtors, these provisions shall remain in full force and effect, and Senior Lender’s claims against such Loan Party and the estate of such Loan Party
shall be paid in full in cash before any payment is made to any Creditor. 
 6. For so long as any of the Senior Debt remains outstanding,
each Creditor irrevocably appoints Senior Lender as such Creditor’s attorney-in-fact, and grants to Senior Lender a power of attorney with full power of substitution, in the name of such Creditor or in the name of Senior Lender, for the use and
benefit of Senior Lender, without notice to such Creditor, to perform at Senior Lender’s option the following acts in any bankruptcy, insolvency or similar proceeding involving any Loan Party: 
 (i) To file the appropriate claim or claims in respect of the Subordinated Debt on behalf of Creditor if Creditor does not do so prior to
30 days before the expiration of the time to file claims in such proceeding and if Senior Lender elects, in its sole discretion, to file such claim or claims; and 
 (ii) To accept or reject any plan of reorganization or arrangement on behalf of Creditor and to otherwise vote Creditor’s claims in
respect of any Subordinated Debt in any manner that Senior Lender deems appropriate for the enforcement of its rights hereunder. 
 7. Each
Creditor shall immediately affix a legend to the instruments evidencing the Subordinated Debt stating that the instruments are subject to the terms of this Agreement. No amendment of the documents evidencing or relating to the Subordinated Debt
shall directly or indirectly modify the provisions of this Agreement in any manner which might terminate or impair the subordination of the Subordinated Debt or the subordination of the security interest or lien that such Creditor may have in any
property of any Loan Party. Until the Senior Debt has been indefeasibly paid in full in cash, and notwithstanding anything to the contrary contained in the Subordinated Debt Documents, neither any Loan Party nor any Creditor shall agree to any
amendment, modification or supplement to the Subordinated Debt Documents, the effect of which is to: 
 (i) increase the
principal amount of the Subordinated Debt or rate of interest or fees on any of the Subordinated Debt (it being understood that the imposition of a default rate of interest for defaults occurring after the date hereof in accordance with the terms of
the Subordinated Debt Documents as in effect on the date hereof shall not be restricted by this clause (i)); 

 (ii) advance any date upon which any payment of principal or interest on the Subordinated
Debt are due; 
 (iii) make more restrictive or add any event of default or any covenant with respect to the Subordinated
Debt; provided, however, that with respect to any new covenant representation, warranty or event of default added to the Senior Debt Documents, the Subordinated Creditors shall be permitted to agree to the addition to the Subordinated Debt Documents
of such new covenant, representation, warranty or event of default; 
 (iv) increase or make more restrictive any redemption
or prepayment provisions of the Subordinated Debt; 
 (v) take any liens or security interests in any assets of any Loan Party
other than as provided in the Subordinated Debt Documents as in effect on the date hereof (other than with respect to assets of the Loan Parties acquired after the date hereof as curently contemplated by the Subordinated Debt Documents); 

(vi) receive a guaranty of all or any portion of the Subordinated Debt (except for guaranties which by their terms are subordinated to
the Senior Debt on substantially identical terms as those set forth in this Agreement); or 
 (vii) make more restrictive any
other term of the Subordinated Debt Documents, increase the obligations of any Loan Party or any guarantor of the Subordinated Debt or confer additional material rights on any Creditor or any other holder of the Subordinated Debt, unless in
accordance with clauses (i) through (vi) above. 
 8. Notwithstanding any covenant or other provision in the Securities Purchase
Agreement, the Subordinated Security Agreement or any other Subordinated Debt Document, each Creditor hereby consents to the incurrence by the Loan Parties of the Senior Debt and to the first priority liens securing the Senior Debt, as well as the
execution, delivery and performance of the Senior Note, the Senior Security Agreement, the other documents from time to time governing the Senior Debt, and the letter agreement, dated the date hereof, between the Borrower and the Senior Lender. The
Creditors party hereto constitute the “Majority Investors” as such term is defined in the Purchase Agreement, and this Agreement shall constitute an amendment and waiver to the Purchase Agreement pursuant to Section 12.7 thereof to
the extent necessary for the Loan Parties to enter into the transactions contemplated by the Senior Debt Documents and the above referenced letter agreement. Such execution, delivery and performance shall not constitute an Event of Default under the
Securities Purchase Agreement. Notwithstanding anything herein to the contrary, neither the Borrower nor the Senior Lender shall agree to any amendment, supplement or other modification of the Senior Debt Documents that extends the scheduled
maturity date of the Senior Debt beyond May 18, 2010. 
 Effective as of the date hereof, the Majority Investors, on behalf of the
Creditors, hereby waive the following event of default under the Subordinated Debt Documents and the right to exercise or enforce any and all rights and remedies available to the Creditors arising therefrom: 
 (i) Acceleration of payments due to Kendle International Inc. which amount is greater than one hundred thousand dollars (the
“Existing Default”). 
 The Senior Lender may at any time and from time to time without the consent of any Creditor, without
incurring liability to any Creditor and without impairing or releasing the obligations of any Creditor under this Agreement, change the manner or place of payment or extend the time of payment of or renew or alter any of the terms of the Senior
Debt, or amend, modify or supplement in any manner any agreement, note, guaranty or other instrument evidencing or securing or otherwise relating to the Senior Debt. 

 9. This Agreement shall remain effective until the indefeasible payment in full in cash of the Senior
Debt. If, at any time after payment in full of the Senior Debt any payments of the Senior Debt must be disgorged by Senior Lender for any reason (including, without limitation, the bankruptcy or insolvency of any Loan Party), this Agreement and the
relative rights and priorities set forth herein shall be reinstated as to all such disgorged payments as though such payments had not been made and each Creditor shall immediately pay over to Senior Lender all payments received with respect to the
Subordinated Debt to the extent that such payments would have been prohibited hereunder. At any time and from time to time, without notice to Creditors, Senior Lender may take such actions with respect to the Senior Debt as Senior Lender, in its
sole discretion, may deem appropriate, including, without limitation, terminating advances to any Loan Party, increasing the principal amount, extending the time of payment, increasing applicable interest rates, renewing, compromising or otherwise
amending the terms of any documents affecting the Senior Debt and any collateral securing the Senior Debt, and enforcing or failing to enforce any rights against any Loan Party or any other person. No such action or inaction shall impair or
otherwise affect Senior Lender’s rights hereunder. Each Creditor waives the benefits, if any, of Civil Code Sections 2809, 2810, 2819, 2845, 2847, 2848, 2849, 2850, 2899 and 3433. 
 10. This Agreement shall bind any successors or assignees of a Creditor and shall benefit any successors or assigns of Senior Lender. This Agreement is
solely for the benefit of each Creditor and Senior Lender and not for the benefit of Borrower, Guarantor or any other party. 
 11. This
Agreement may be executed in two or more counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. 
 12. This Agreement shall be governed by, and construed in accordance with, the internal laws of the State of California, without regard to principles of conflicts of law. Jurisdiction shall lie in the state and
Federal courts located in the [County of Santa Clara, State of California]. THE UNDERSIGNED ACKNOWLEDGE THAT THE RIGHT TO TRIAL BY JURY IS A CONSTITUTIONAL ONE, BUT THAT IT MAY BE WAIVED UNDER CERTAIN CIRCUMSTANCES. TO THE EXTENT PERMITTED BY LAW,
EACH PARTY, AFTER CONSULTING (OR HAVING HAD THE OPPORTUNITY TO CONSULT) WITH COUNSEL OF ITS, HIS OR HER CHOICE, KNOWINGLY AND VOLUNTARILY, AND FOR THE MUTUAL BENEFIT OF ALL PARTIES, WAIVES ANY RIGHT TO TRIAL BY JURY IN THE EVENT OF LITIGATION
ARISING OUT OF OR RELATED TO THIS AGREEMENT OR ANY OTHER DOCUMENT, INSTRUMENT OR AGREEMENT BETWEEN THE UNDERSIGNED PARTIES. 
 If the jury
waiver set forth in Section is not enforceable, then any dispute, controversy or claim arising out of or relating to this Agreement or any of the transactions contemplated therein shall be settled by judicial reference pursuant to Code of Civil
Procedure Section 638 et seq. before a referee sitting without a jury, such referee to be mutually acceptable to the parties or, if no agreement is reached, by a referee appointed by the Presiding Judge of the [California Superior Court for
Santa Clara County]. This Section shall not restrict a party from exercising remedies under the Code or from exercising pre-judgment remedies under applicable law. 
 13. This Agreement represents the entire agreement with respect to the subject matter hereof, and supersedes all prior negotiations, agreements and commitments. No Creditor is relying on any representations by Senior
Lender or any Loan Party in entering into this Agreement, and each Creditor has kept and will continue to keep itself fully apprised of the financial and other condition of Borrower. This Agreement may be amended only by written instrument signed by
the Majority Investors, on behalf of the Creditors, and Senior Lender. 
 IN WITNESS WHEREOF, the undersigned have executed this Agreement as
of the date first above written. 
 [SIGNATURE PAGES FOLLOW] 

			
	“Senior Lender”
	
	ARCION THERAPEUTICS, INC.
		
	By:	 	/s/ James N. Campbell, M.D
	Name:	 	James N. Campbell, M.D.
	Title:	 	Chief Executive Officer

			
	“Creditors”
	
	SOFINNOVA VENTURE PARTNERS VII, L.P.
		
	By:	 	 Sofinnova Management VII, L.L.C.
 Its General Partner

		
	By:	 	 
		 	Managing General Partner
	
	ALTA CALIFORNIA PARTNERS III, L.P.
		
	By:	 	Alta California Management Partners III, LLC
		
	By:	 	/s/ Daniel S. Janney
		 	Managing Director
	
	ALTA EMBARCADERO PARTNERS III, LLC
		
	By:	 	/s/ Daniel S. Janney
		 	Vice President of Finance & Administration
	
	ALTA PARTNERS VIII, LP
		
	By:	 	Alta Partners Management VIII, LLC
		
	By:	 	/s/ Daniel S. Janney
		 	Managing Director

					
	
	CMEA VENTURES VII, L.P.
		
	By:	 	 CMEA Ventures VII GP, L.P.,
 Its General
Partner

		
	By:	 	 CMEA Ventures VII GP, LLC,
 Its General
Partner

		
	By:	 	/s/ David J. Collier, M.D.
		 	Name:	 	David J. Collier, M.D.
		 	Title:	 	Manager
	
	CMEA VENTURES VII (PARALLEL), L.P.
		
	By:	 	 CMEA Ventures VII GP, L.P.,
 Its General
Partner

		
	By:	 	 CMEA Ventures VII GP, LLC,
 Its General
Partner

		
	By:	 	/s/ David J. Collier, M.D.
		 	Name:	 	David J. Collier, M.D.
		 	Title:	 	Manager
	
	INTERWEST PARTNERS VIII, LP
	INTERWEST INVESTORS VIII, LP
	INTERWEST INVESTORS Q VIII, LP
		
	By:	 	 InterWest Management Partners VIII, LLC,
 General Partner

		
	By:	 	/s/ W. Stephen Holmes
		 	W. Stephen Holmes
		 	Managing Director

 [SIGNATURES CONTINUED ON NEXT PAGE] 

			
	“Borrower”
	
	ANESIVA, INC.
		
	By:	 	/s/ Michael L. Kranda
	Name:	 	Michael L. Kranda
	Title:	 	President and CEO
	
	“Guarantor”
	
	ALGORX PHARMACEUTICALS, INC.
		
	By:	 	/s/ Michael L. Kranda
	Name:	 	Michael L. Kranda
	Title:	 	President and CEO

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