Document:

Second Supplemental Indenture

 Exhibit 4.1 
  

 SECOND SUPPLEMENTAL INDENTURE

 dated as of October 20, 2006 
 by and between 
 CINACALCET ROYALTY SUB LLC, 
 a Delaware limited liability company, 
 as issuer of the Notes, 
 and 
 U.S. BANK NATIONAL ASSOCIATION,

 as initial trustee of the Notes 
 (Second Supplemental Indenture to the Indenture, dated as of December 22, 2004, between 
 Cinacalcet Royalty Sub LLC and U.S.
Bank National Association, as previously amended by the 
 Supplemental Indenture, dated as of February 5, 2005) 
  

 SECOND SUPPLEMENTAL INDENTURE 
 SECOND SUPPLEMENTAL INDENTURE, dated as of October 20, 2006 (this “Supplemental Indenture”), by and between CINACALCET ROYALTY SUB
LLC, a Delaware limited liability company, as issuer of the Notes (the “Issuer”), and U.S. BANK NATIONAL ASSOCIATION, a national banking association, as initial trustee of the Notes (the “Trustee”), supplemental to
the Indenture, dated as of December 22, 2004, as previously amended by the Supplemental Indenture, dated as of February 5, 2005 (the “Indenture”), made and entered into by and between the Issuer and the Trustee.
Capitalized terms used but not defined herein have the same meanings assigned such terms in the Indenture. 
 RECITALS OF ISSUER 

A. The Issuer and the Trustee are parties to the Indenture, providing for, among other things, the authentication, delivery and administration of the
Issuer’s Secured 8% Notes due 2017 (the “Notes”). 
 B. The Issuer has proposed certain amendments to permit and
facilitate the pledge by NPS Pharmaceuticals, Inc. (“NPS”) or one of its subsidiaries of the equity interests of Issuer in connection with any financings NPS or its subsidiary may enter into from time to time in the future. 
 C. The Issuer has received the consent of a majority of the Outstanding Principal Balance of the Notes to the amendments set forth below in accordance
with Section 9.01 of the Indenture. 
 D. The Issuer has directed the Trustee to execute and deliver this Supplemental Indenture in
accordance with the terms of the Indenture. 
 NOW, THEREFORE, IT IS HEREBY COVENANTED AND AGREED by and between the parties hereto as
follows: 
 ARTICLE I 
 AMENDMENTS TO INDENTURE 
 Section 1.01 Amendments to Indenture. The Indenture is hereby amended as follows:

 (a) Article VI of the Table of Contents of the Indenture is hereby amended by deleting “Section 6.12 Pledge Agreement” in its
entirety and replacing it with “Section 6.12 Reserved.” 
 (b) Section 1.01 of the Indenture is hereby amended by:

 (i) Deleting the definition of “Pledge Agreement” in its entirety; 
 (ii) Deleting the definition of “Pledged Equity” in its entirety; 

 (iii) Deleting the definition of “Related Documents” in its entirety and
replacing it with the following: 
 “Related Documents” means the Purchase and Sale Agreement, the
License Agreement, this Indenture and the Notes.; 
 (iv) Deleting the definition of “Secured Party” in its
entirety; and 
 (v) Deleting the definition of “Security Interests” in its entirety and replacing it with the
following: 
 “Security Interests” means the security interests granted or expressed to be granted in the
Collateral pursuant to the Granting Clause herein. 
 (c) Section 4.03 of the Agreement is hereby amended by: 
 (i) Deleting the comma between “the Notes” and “this Indenture” in the fourth line of the introductory paragraph and
replacing it with “or”; and 
 (ii) Deleting “or the Pledge Agreement” immediately following “this
Indenture” in the fourth and fifth lines. 
 (d) Section 4.04 of the Agreement is hereby amended by deleting “, the Pledge
Agreement” in the third line of the introductory paragraph. 
 (e) Section 5.02(a) of the Indenture is hereby deleted in its
entirety and replaced with the following: 
 No Release of Obligations. Except as expressly permitted by this
Indenture, the Issuer shall not take any action, whether orally or in writing, which would amend, modify, supplement, restate, cancel or terminate or discharge or prejudice the validity or effectiveness of this Indenture or the Purchase and Sale
Agreement, or permit any party to any such document to be released from such obligations. 
 (f) Section 5.02(f) of the Indenture is
hereby deleted in its entirety and replaced with the following: 
 Limitation on the Issuance, Delivery and Sale of Capital
Stock. Except for any additional Stock issued to NPS, the Issuer shall not, directly or indirectly, issue, deliver or sell, or consent to issue, deliver or sell any actual, contingent, future or executory membership interests, limited liability
company interests, beneficial interests or other equity or ownership interests (however designated, whether voting or non-voting); provided, however, that the transfer of all or a portion of the equity interests of the Issuer to another party shall
not be deemed the issuance, delivery or sale of such interest if concurrently with such transfer the Issuer delivers to the Trustee an Officer’s Certificate and an Opinion of Counsel to the effect that such transfer does not impair in any
respect the continuing lien of this Indenture in the Collateral. Additionally, the Issuer shall not accept any capital contributions after the Closing Date except for contributions by NPS of 
 funds deposited into the Capital Account, which may be used only as provided in Section 3.01(h). 

 (g) Section 6.12 of the Indenture is hereby deleted in its entirety and replaced with
“Reserved.” 
 Section 1.02 Receipt by Trustee. In accordance with Section 9.04 of the Indenture, the parties
acknowledge that the Trustee has received an Officer’s Certificate and an Opinion of Counsel as conclusive evidence that this Supplemental Indenture complies with the applicable requirements of the Indenture. 
 ARTICLE II 
 MISCELLANEOUS 

Section 2.01 Ratification of Indenture; Supplemental Indenture Part of Indenture. Except as expressly amended hereby, the Indenture is in all
respects ratified and confirmed and all the terms, conditions and provisions thereof shall remain in full force and effect. This Supplemental Indenture shall form a part of the Indenture for all purposes, and shall be read and construed together
with the Indenture, and every Note heretofore or hereafter authenticated and delivered under the Indenture shall be bound thereby. 
 Section
2.02 Severability. In the event that any provision of this Supplemental Indenture or the application thereof to any party hereto or to any circumstance or in any jurisdiction governing this Supplemental Indenture shall, to any extent, be
invalid or unenforceable under any applicable statute, regulation or rule of law, then such provision shall be deemed inoperative to the extent that it is invalid or unenforceable and the remainder of this Supplemental Indenture, and the application
of any such invalid or unenforceable provision to the parties, jurisdictions or circumstances other than to whom or to which it is held invalid or unenforceable, shall not be affected thereby nor shall the same affect the validity or enforceability
of this Supplemental Indenture. 
 Section 2.03 Governing Law. THIS SUPPLEMENTAL INDENTURE SHALL IN ALL RESPECTS BE GOVERNED BY, AND
CONSTRUED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK, INCLUDING ALL MATTERS OF CONSTRUCTION, VALIDITY AND PERFORMANCE. 
 Section
2.04 Counterparts. This Supplemental Indenture may be executed in one or more counterparts by the parties hereto, and each such counterpart shall be considered an original and all such counterparts shall constitute one and the same
instrument. 
 Section 2.05 Headings, Etc. The headings of the Articles and Sections of this Supplemental Indenture have been inserted
for convenience of reference only, are not to be considered a part hereof and shall in no way modify or restrict any of the terms and provisions hereof. 
 Section 2.06 Benefits of Supplemental Indenture. Nothing in this Supplemental Indenture, expressed or implied, shall give any Person, other than the parties hereto, any Registrar and any Paying Agent, and their
respective successors hereunder and the Holders, any benefit or any legal or equitable right, remedy or claim under this Supplemental Indenture or the Indenture. 

 Section 2.07 Acceptance by Trustee. The Trustee hereby accepts the modifications of the Indenture
effected by this Supplemental Indenture. 
 [SIGNATURE PAGE FOLLOWS] 

 IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture to be duly executed, all
as of the date first written above. 
  

			
	 CINACALCET ROYALTY SUB LLC, as Issuer

		
	By:	 	 /s/ Kevin J. Ontiveros

	Name:	 	
	Title:	 	
	
	 U.S. BANK NATIONAL ASSOCIATION, not in its individual capacity but solely as Trustee

		
	By:	 	 /s/ Raymond S. Haverstock

	Name:	 	
	Title:Third Supplemental Indenture

 Exhibit 4.2 
  

 THIRD SUPPLEMENTAL INDENTURE

 dated as of July 9, 2007 
 by and between 
 CINACALCET ROYALTY SUB LLC, 
 a Delaware limited liability company, 
 as issuer of the Notes, 
 and 
 U.S. BANK NATIONAL ASSOCIATION.

 as initial trustee of the Notes 
 (Third Supplemental Indenture to the Indenture, dated as of December 22, 2004, between 
 Cinacalcet Royalty Sub LLC and U.S.
Bank National Association, as previously amended by the 
 Supplemental Indenture, dated as of February 5, 2005 and Second Supplemental
Indenture, dated 
 as of October 20, 2006) 
  

 THIRD SUPPLEMENTAL INDENTURE 
 THIRD SUPPLEMENTAL INDENTURE, dated as of July 9, 2007 (this “Supplemental Indenture”), by and between CINACALCET ROYALTY SUB LLC,
a Delaware limited liability company, as issuer of the Notes (the “Issuer”), and U.S. BANK NATIONAL ASSOCIATION, a national banking association, as initial trustee of the Notes (the “Trustee”), supplemental to the
Indenture, dated as of December 22, 2004, as previously amended by the Supplemental Indenture, dated as of February 5, 2005 and the Second Supplemental Indenture, dated as of October 20, 2006 (the “Indenture”), made
and entered into by and between the Issuer and the Trustee. Capitalized terms used but not defined herein have the same meanings assigned such terms in the Indenture. 
 RECITALS OF ISSUER 
 A. The Issuer and the Trustee are parties to the Indenture, providing for, among other
things, the authentication, delivery and administration of the Issuer’s Secured 8% Notes due 2017. 
 B. The Issuer has proposed an
amendment to cure an ambiguity in, correct or supplement a defective or inconsistent provision of, or to add to or modify a provision or agreement in the Indenture pursuant to Section 9.02(c) in order to permit the Issuer to distribute proceeds
from the issuance of any subsequent Note issued under the Indenture to the owners of beneficial interests in the Issuer. 
 C. The Issuer has
requested that the Trustee execute and deliver this Supplemental Indenture in accordance with the terms of the Indenture. 
 NOW, THEREFORE,
IT IS HEREBY COVENANTED AND AGREED by and between the parties hereto as follows: 
 ARTICLE I 
 AMENDMENTS TO INDENTURE 
 Section 1.01 Amendment to Indenture. Section 5.02(b) of the Indenture is hereby amended by inserting after the phrase in clause (i) “with respect to any ownership of its Stock” the following words,
“except that the Issuer may distribute to NPS or any owner of a beneficial interest in the Issuer any proceeds from an issuance of Notes in accordance with this Indenture”. 
 Section 1.02 Receipt by Trustee. In accordance with Section 9.04 of the Indenture, the parties acknowledge that the Trustee has received
an Officer’s Certificate and an Opinion of Counsel as conclusive evidence that this Supplemental Indenture complies with the applicable requirements of the Indenture. 

 ARTICLE II 
 MISCELLANEOUS 
 Section 2.01 Ratification of Indenture; Supplemental Indenture Part of
Indenture. Except as expressly amended hereby, the Indenture is in all respects ratified and confirmed and all the terms, conditions and provisions thereof shall remain in full force and effect. This Supplemental Indenture shall form a part of
the Indenture for all purposes, and shall be read and construed together with the Indenture, and every Note heretofore or hereafter authenticated and delivered under the Indenture shall be bound thereby. 
 Section 2.02 Severability. In the event that any provision of this Supplemental Indenture or the application thereof to any party hereto or
to any circumstance or in any jurisdiction governing this Supplemental Indenture shall, to any extent, be invalid or unenforceable under any applicable statute, regulation or rule of law, then such provision shall be deemed inoperative to the extent
that it is invalid or unenforceable and the remainder of this Supplemental Indenture, and the application of any such invalid or unenforceable provision to the parties, jurisdictions or circumstances other than to whom or to which it is held invalid
or unenforceable, shall not be affected thereby nor shall the same affect the validity or enforceability of this Supplemental Indenture. 
 Section 2.03 Governing Law. THIS SUPPLEMENTAL INDENTURE SHALL IN ALL RESPECTS BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK, INCLUDING ALL MATTERS OF CONSTRUCTION, VALIDITY AND PERFORMANCE.

 Section 2.04 Counterparts. This Supplemental Indenture may be executed in one or more counterparts by the parties hereto, and
each such counterpart shall be considered an original and all such counterparts shall constitute one and the same instrument. 
 Section 2.05 Headings, Etc. The headings of the Articles and Sections of this Supplemental Indenture have been inserted for convenience of reference only, are not to be considered a part hereof and shall in no way modify or
restrict any of the terms and provisions hereof. 
 Section 2.06 Benefits of Supplemental Indenture. Nothing in this Supplemental
Indenture, expressed or implied, shall give any Person, other than the parties hereto, any Registrar and any Paying Agent, and their respective successors hereunder and the Holders, any benefit or any legal or equitable right, remedy or claim under
this Supplemental Indenture or the Indenture. 
 Section 2.07 Acceptance by Trustee. The Trustee hereby accepts the modifications
of the Indenture effected by this Supplemental Indenture. 
 [SIGNATURE PAGE FOLLOWS] 
  

 2 

 IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture to be duly executed, all
as of the date first written above. 
  

			
	 CINACALCET ROYALTY SUB LLC, as Issuer

		
	By:	 	 /s/ Val Antczak

	Name:	 	Val Antczak
	Title:	 	Secretary
	
	 U.S. BANK NATIONAL ASSOCIATION, not in its individual capacity but solely as Trustee

		
	By:	 	 /s/ Raymond S. Haverstock

	Name:	 	Raymond S. Haverstock
	Title:	 	Vice President

  

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