Document:

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                      FOURTH AMENDMENT TO LOAN AGREEMENT
                      ----------------------------------

    THIS FOURTH AMENDMENT TO LOAN AGREEMENT (this "Amendment") is entered
into as of the 17th day of December, 1999 by and among LaSalle Bank National
Association, a national banking association ("Bank"), and each of K-V
Pharmaceutical Company, a Delaware corporation ("K-V"), Particle Dynamics,
Inc. ("PDI"), a New York corporation, ETHEX Corporation, a Missouri
corporation ("ETHEX") (K-V, PDI and ETHEX are collectively referred to as the
"Original Borrowers"), and Ther-Rx Corporation, a Missouri corporation
("Ther-Rx") (K-V, PDI, ETHEX and Ther-Rx are collectively referred to as the
"Borrowers").

                                 WITNESSETH:

    WHEREAS, Bank and the Original Borrowers entered into that certain Loan
Agreement dated as of June 18, 1997, as amended by that certain First
Amendment to Loan Agreement dated as of October 28, 1998, that certain Second
Amendment to Loan Agreement dated as of March 11, 1999 and that certain Third
Amendment to Loan Agreement dated as of June 22, 1999 (collectively, The
"Agreement"); and

    WHEREAS, the Bank and the Original Borrowers desire to amend the
Agreement to extend the maturity date of the Revolving Credit Commitment and
to add Ther-Rx as a Borrower under the Revolving Credit Commitment.

    NOW, THEREFORE, for and in consideration of the premises and mutual
agreements herein contained and for the purposes of setting forth the terms
and conditions of this Amendment, the parties, intending to be bound, hereby
agree as follows:

    1.   Incorporation of the Agreement.  All capitalized terms which are not
         ------------------------------
defined hereunder shall have the same meanings as set forth in the Agreement,
and the Agreement, to the extent not inconsistent with this Amendment, is
incorporated herein by this reference as though the same were set forth in
its entirety. To the extent any terms and provisions of the Agreement are
inconsistent with the amendments set forth in Paragraph 2 below, such terms
                                              -----------
and provisions shall be deemed superseded hereby. Except as specifically set
forth herein, the Agreement shall remain in full force and effect and its
provisions shall be binding on the parties hereto.

    2.   Amendment of the Agreement.  Borrowers and Bank hereby agree to
         --------------------------
amend the Agreement as follows:

         (a) the definitions of the terms "Revolving Credit Maturity Date"
             and "Revolving Note" appearing in Paragraph 1.1 are hereby
                                               -------------
             amended and restated as follows:

         "Revolving Credit Maturity Date" means October 15, 2002.

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         "Revolving Note" means that certain Substitute Revolving Note dated
          --------------
         as of December 17, 1999 made payable by Borrowers in favor of Bank in
         the maximum principal amount of Forty Million Dollars ($40,000,000),
         as the same may be amended, modified or supplemented from time to
         time, and together with any renewals thereof or exchanges or
         substitutes therefor.

         (b) Ther-Rx is hereby made a party to the Agreement and agrees to be
bound by the terms and conditions of the Agreement as of the date hereof, and
Ther-Rx hereby assumes all obligations and is entitled to the rights and
benefits of a Borrower under the Agreement.  From and after the date hereof,
any and all references to the Borrowers shall be deemed to include Ther-Rx,
except for references to the Borrowers relating to their status prior to this
Amendment and with respect to representations and warranties made as of or with
respect to a specific prior date(s).

    3.   Delivery of Documents.  The following documents and other items shall
         ---------------------
be delivered concurrently with this Amendment:

         a.  Substitute Revolving Note;
         b.  Legal Opinion of Counsel to Borrowers;
         c.  Insurance Certificate for Ther-Rx reflecting Bank as Lender's
             loss payee and additional insured;
         d.  Secretary's Certificate of Ther-Rx; and
         e.  Such other documents, certificates and financing statements as
             Bank shall request.

    4.   Representations, Covenants and Warranties; No Default. The
         -----------------------------------------------------
representations, covenants and warranties set forth in Paragraph 8 of the
                                                       -----------
Agreement (other than as set forth on the schedules to such representations,
warranties and covenants attached hereto as Exhibit 1 replacing the schedules
                                            ---------
delivered in connection with the Loan Agreement dated June 18, 1997) shall be
deemed remade as of the date hereof by each Borrower (including Ther-Rx),
except (that any and all references to the Agreement in such representations
and warranties shall be deemed to include this Amendment.  No Event of
Default has occurred and is continuing and no event has occurred and is
continuing which, with the lapse of time, the giving of notice, or both,
would constitute such an Event of Default under the Agreement.

    5.   Fees and Expenses.  The Borrowers agree to pay on demand all costs
         -----------------
and expenses of or incurred by Bank in connection with the evaluation,
negotiation, preparation, execution and delivery of this Amendment.

    6.   Effectuation.  The amendments to the Agreement contemplated by this
         ------------
Amendment shall be deemed effective immediately upon the full execution of
this Amendment and without any further action required by the parties hereto.
There are no conditions precedent or subsequent to the effectiveness of this
Amendment.

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    7.   Counterparts.  This Amendment may be executed in two or more
         ------------
counterparts, each of which shall be deemed an original, and all of which
together shall constitute one and the same instrument.

    8.   Revised UCC Provisions.  It is the intention of the parties hereto
         ----------------------
that the priorities and agreements herein contained continue to apply after
the enactment by the various States of Revised Article 9 -- Secured
Transactions (with conforming amendments to Articles 1, 2, 2a, 4, 5, 6, 7 and
8) to the UCC as approved by The American Law Institute in 1998 and approved
and recommended for enactment in all the States by the National Conference of
Commissioners for Uniform State Laws in 1998 ("Revised Article 9") and the
effectiveness of Revised Article 9 in any State. After the effectiveness of
Revised Article 9 in any State, (i) all section references herein to, and all
defined terms used herein defined in, Article 9 of the UCC as currently in
effect shall be deemed to be to any corresponding Section or definition of
Revised Article 9, and (ii) if any definition used herein by reference to
Revised Article 9 is broader than the corresponding definition used in
current Article 9 of the UCC, such broader definition will apply herein.

                          [ SIGNATURE PAGE FOLLOWS ]

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    IN WITNESS WHEREOF, the parties hereto have duly executed this Fourth
Amendment to Loan Agreement as of the date first above writtten.

LASALLE BANK NATIONAL ASSOCIATION      K-V PHARMACEUTICAL COMPANY

By:  /s/ Michael S. Barnett            By:  /s/ Gerald R. Mitchell
     -----------------------------          -----------------------------
Its:     Vice President                Its:     Vice President, Finance
     -----------------------------          -----------------------------

                                       PARTICLE DYNAMICS, INC.

                                       By:  /s/ Gerald R. Mitchell
                                            -----------------------------
                                       Its:     Vice President
                                            -----------------------------

                                       ETHEX CORPORATION

                                       By:  /s/ Gerald R. Mitchell
                                            -----------------------------
                                       Its:     Vice President
                                            -----------------------------

                                       THER-RX CORPORATION

                                       By:  /s/ Gerald R. Mitchell
                                            -----------------------------
                                       Its:     Vice President
                                            -----------------------------<PAGE> 1

                            STOCK OPTION AGREEMENT

DATE:                                                   OPTION NUMBER: SP-13

APRIL 1, 1999                                   NUMBER OF SHARES PURCHASABLE
                                                                      75,000

                            TO PURCHASE SHARES OF

                             CLASS B COMMON STOCK

                                     -OF-

                          K-V PHARMACEUTICAL COMPANY

THIS CERTIFIES THAT Marc S. Hermelin is hereby granted the option to
purchase, at the option price of $16.563 per share, all or any part of that
number of fully paid and non-assessable shares of the Class B Common Stock,
par value $0.01 per share ("Class B Common Stock"), of K-V Pharmaceutical
Company, a Delaware corporation (hereinafter called the "Company") above set
forth, upon and subject to the following terms and conditions:

    This Option and all rights to purchase shares hereunder shall expire four
(4) years from the date hereof (hereinafter called the "expiration date").

    This Option and all rights hereunder shall be assignable and
transferable.

    As of April 1, 1999, and Prior to its expiration or earlier termination,
this Option shall be exercisable from time to time as to all or any of the
shares then purchasable hereunder as follows: During the four-year period
commencing April 1, 1999 and ending March 31, 2003, it may be exercised as to
all or any shares at any time during which this Option shall be exercisable
as to the shares subject hereto.

    This Option may be exercised from time to time only by delivery to the
Company at its main office (attention of the Secretary) of a duly signed
notice in writing stating the number of shares with respect to which this
Option is being exercised and the time and date of delivery thereof, which
time and date of delivery shall be during the normal business hours of the
Company on a regular business day not less than fifteen (15) days after the
giving of such notice unless an earlier date has been mutually agreed upon:
provided, however, that not less than ten (10) shares may be purchased at any
one time unless the number purchased is the total number then purchasable
hereunder: and provided further that this Option may not be exercised at any

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time when this Option or the granting or exercise hereof violates any law or
governmental order or regulation. At the time of delivery specified in such
notice, the Company shall, without transfer or issue tax to the holder (or
other person entitled to exercise this Option) transfer and set aside for the
benefit of the holder (or other person entitled to exercise this Option) a
certificate or certificates out of the Company's theretofore authorized but
unissued or reacquired shares of Class B Common Stock as the Company may
elect (with appropriate legend thereon, if deemed necessary by the Company,
containing the representation by the person exercising the Option that the
shares purchased shall be for investment purposes and not with a view to
resale or distribution) against payment of the option price in full for the
number of shares purchased by either (i) cash (including a certified or bank
cashier's check or the equivalent thereof), or (ii) at the discretion of the
Board, by delivering at fair market value, as determined by the Board,
Company Common Stock already owned by the Participant, or (iii) any
combination of cash and Company Common Stock, to be held by the Company and
subsequently delivered to the holder (or such other person) as hereinafter
provided.  If the holder fails to pay for any part of the number of shares
specified in such notice as required, the right to purchase such shares may
be terminated by the Board.

    To the extent that this Option has not been exercised in full prior to
its termination or expiration date, whichever occurs sooner, it shall
terminate and become void and of no effect.

    All Class B Common Stock purchased pursuant to the exercise of an Option
shall be held by the Company for a period of two years from the date of
exercise (the "Holding Period").

    Upon completion of the Holding Period (under normal Company policies),
the Company shall deliver to the holder or the holder's personal
representative, as soon as practicable thereafter, certificates representing
the Class B Common Stock purchased hereunder (the "Certificates"), free and
clear of restrictions except for the restrictions which are necessary to
assure compliance by the Company and the holder with applicable federal and
state securities laws and/or the listing requirements of any national
securities exchange.

    This Option shall not confer upon the holder any right to remain in the
employ of the Company or any subsidiary thereof and shall not confer upon the
holder any rights in the stock of the Company prior to the issuance of a
stock certificate pursuant to the exercise of this Option.  No adjustment
shall be made for dividends or other rights for which the record date is
prior to the date such stock certificate is issued.

    In the event that the outstanding shares of Class B Common Stock of
the Company are hereafter increased or decreased or changed into or exchanged
for a different number or kind of shares or other securities of the Company
or of another corporation, or in the event that there is a "corporate
transaction" as that term is defined in the Regulations under Section 425
of the Internal Revenue Code of 1986, by reason of reorganization, merger,
consolidation, recapitalization, reclassification, stock split-up, spin-off,
combination of shares or dividend payable in capital stock, this Option
shall, to the extent that it has not been exercised, entitle the holder upon
the subsequent exercise of this Option to such number and kind of securities
or other property, subject to the terms of the Option, to which the holder
would be entitled had the holder

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actually owned the shares subject to the unexercised portion of this Option
at the time of the occurrence of such event, and the aggregate purchase price
upon the subsequent exercise of this Option shall be the same as if the Class
B Common Stock of the Company originally optioned were being purchased as
provided herein; provided, however, that each such adjustment in the number
and kind of shares subject to this Option, including any adjustment in the
Option price, shall be made in such manner as not to constitute a
"modification" as defined in Section 425 of the Internal Revenue Code of
1986. Any such adjustment made by the Board of Directors shall be conclusive.

    The Company may postpone the issuance and delivery of shares upon any
exercise of this Option, if necessary, until admission of such shares to
listing on any stock exchange and completion of registration and
qualification of such shares under any applicable state or federal law, rule
or regulation.

    The holder hereof shall make such representations and furnish such
information to the Company as may be appropriate to permit the Company to
issue such shares in compliance with the provisions of the Security Act of
1933, as amended (the "Securities Act"), or any other applicable law,
including state securities laws.  Without limiting the generality of the
foregoing, if requested by the Company, the holder will represent, in form
acceptable to the Company, that the holder is purchasing any shares issued
pursuant hereto for investment purposes and not with a view to resale or
distribution.

    This Option is issued pursuant to the resolutions duly adopted by the
Board of Directors, the receipt of a copy of which the holder acknowledges by
virtue of the acceptance hereof, and is subject to all the terms and
conditions of said resolutions.

    A determination by the Board of Directors of any questions which may
arise with respect to the interpretation and construction of the provisions
of this Option shall be final.

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    WITNESS the seal of the Company and the Signatures of its duly authorized
officers or agents.

Dated: April 1, 1999

                                          K-V PHARMACEUTICAL COMPANY

                                          By:  /s/ Gerald R. Mitchell
                                               -----------------------------
                                                     Vice President, Finance

ACCEPTED:

/s/ Marc S. Hermelin
-----------------------------
Marc S. Hermelin

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