Document:

Amendment No. 1 to the Third Amended and Restated Investors' Rights Agreement

 EXHIBIT 4.2 
 AMENDMENT NO. 1 TO THE THIRD AMENDED AND RESTATED 
 INVESTORS’ RIGHTS AGREEMENT 
 This AMENDMENT NO. 1 THE THIRD AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT is dated as of December 28, 2007 (this “Amendment”)
and is entered into by and among NeurogesX, Inc., a Delaware corporation (the “Company”), the parties defined as “Investors” in the IRA (as defined below) (each a “Prior Investor,” and collectively, the “Prior
Investors”), and the parties listed on Exhibit A to the SPA (as defined below) (each a “Purchaser,” and collectively, the “Purchasers”). The Third Amended and Restated Investors’ Rights Agreement dated as of
November 14, 2005, as amended, shall be hereinafter referred to as the “IRA.” 
 RECITALS 
 WHEREAS, The Purchasers are purchasing shares of Common Stock of the Company (the “Shares”) and warrants to purchase shares of Common Stock of
the Company (the “Warrants”) pursuant to a Securities Purchase Agreement, dated as of December 23, 2007, by and among the Company and the Purchasers (the “SPA”); 
 WHEREAS, the Company and the undersigned Prior Investors (on behalf of all Prior Investors) desire the Purchasers to have certain registration rights
with respect to the Shares and the shares of Common Stock of the Company issuable upon exercise of the Warrants (the “Underlying Shares,” along with the Shares, collectively, the “Securities”) pursuant to Sections 1.1 through 1.4
and Sections 1.6 through 1.14 of the IRA, by and among the Company and the Prior Investors, and that the Purchasers be added to the Rights Agreement as parties thereto for the purpose of granting such registration rights; 
 WHEREAS, Section 4.3 of the IRA allows the amendment or waiver of such IRA with the written consent of the Company and the holders of at least a
majority Registrable Securities, as defined in the IRA, outstanding (the “Majority Holders”); and 
 NOW, THEREFORE,
in consideration of the promises contained herein and for other good and valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged by the parties hereto, the parties hereby covenant and agree as follows:

 1. The Securities shall constitute “Registrable Securities,” as such term is defined in Section 1.1(g) of the IRA, for all
intents and purposes of the registration rights and related provisions and obligations set forth in Sections 1.1 through 1.4, Sections 1.6 through 1.14 and Section 4 of the IRA. 
 2. The Purchasers shall be treated for all purposes under Sections 1.1 through 1.4, Sections 1.6 through 1.14, and Section 4 of the IRA as
“Holders,” as such term is defined in Section 1.01(d) of the IRA; provided however, that the Purchasers shall not be considered “Initiating Holders” as such term is defined in Section 1.1(e). 

 3. Notwithstanding the foregoing, if the Registration Statement on Form S-3 required to be filed pursuant
to the Registration Rights Agreement, dated as of December 23, 2007, by and among the Company and the Purchasers (the “RRA”), is not declared effective or ceases to be effective, or if Form S-3 is not available to the Company to
register the Securities under Rule I.B.1 of Form S-3, the Purchasers shall have the right to request up to two demand registrations for underwritten public offerings pursuant to the terms of Section 1.2 of the IRA as if the Purchasers were
“Initiating Holders” under such section (without regard, except as set forth below, to the share and dollar threshold requirements set forth in Sections 1.1(e) and 1.2(a)(A), respectively, of the IRA), provided, however, that the Company
shall not be required to carry out any such demand registration unless such registration is requested in writing after June 30, 2008 by Purchasers holding at least 30% of the Securities. The Purchaser’s rights to demand registration
pursuant to this Section 3 shall terminate two years after the Initial Closing Date, as defined in the RRA. 
 4. The Purchasers agree to
be bound by the terms and conditions of Sections 1.1 through 1.4, Sections 1.6 through 1.14 and Section 4 of the Rights Agreement and shall succeed to and assume all of the rights and obligations of Holders of Registrable Securities for all
intents and purposes of such Sections, provided that, the Purchasers shall not be deemed to possess any rights set forth in Sections 2 or 3 of the Rights Agreement. 
 5. All notices and other communications under the IRA shall be made to the Purchasers at the addresses specified in Exhibit A to the SPA, and thereafter at such other address, notice of which is given in accordance
with Section 4.4 of the IRA. 
 6. To facilitate the sale and issuance of the Securities and the proposed registration of the Securities
pursuant to a Registration Statement on Form S-3 under the RRA, the Prior Investors (on their own behalf and on behalf of all Prior Investors for purposes of the IRA) furthermore hereby waive the following as such apply to such Form S-3 registration
of the Securities: (i) any right to prior or other notice of a Form S-3 registration carried out pursuant to the RRA; (ii) the 20 day period, set forth in Section 1.3 of the IRA, in which the Prior Investors may otherwise be able to
respond to notice by the Company of a Form S-3 registration carried out pursuant to the RRA; (iii) any and all registration rights under the IRA that would require the Company to register in a Form S-3 registered pursuant to the RRA any shares
of Company Common Stock held by the Prior Investors; and (iv) any other conflict that may arise between the IRA and the RRA. 
 7. The
Prior Investors hereby (on their own behalf and on behalf of all Prior Investors for purposes of the IRA) consent to the grant to the Purchasers of the piggyback and demand registration rights set forth herein, and hereby waive any conflicts that
may arise between the terms hereof and the terms of the IRA. 
 8. The IRA as modified herein shall remain in full force and effect as so
modified. 
 [Signature Pages Follow] 

 IN WITNESS WHEREOF, the parties hereto have executed this Amendment as of
the date first written above. 
  

			
	NEUROGESX, INC.
		
	By:	 	 /s/ Stephen Ghiglieri

	Name:	 	Stephen Ghiglieri
	Title:	 	Chief Financial Officer

 THE PURCHASER’S SIGNATURE TO THE INVESTOR QUESTIONNAIRE DATED OF EVEN DATE HEREWITH SHALL CONSTITUTE THE
PURCHASER’S SIGNATURE TO THIS AMENDMENT NO. 1 THE THIRD AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT. 
  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	Alta California Partners II, L.P.
		
	By:	 	 Alta California Management Partners II,
 LLC

	Its:	 	General Partner
		
	By:	 	 /S/ ALIX MARDUEL

		 	 Member

	
	Alta Embarcadero Partners II, LLC
		
	By:	 	 /S/ ALIX MARDUEL 

		 	 Under Power of Attorney

	
	Alta California Partners II, L.P. – New Pool
		
	By:	 	Alta California Management Partners II, LLC – New Pool, its General Partner
		
	By:	 	 /S/ ALIX MARDUEL

		 	 Managing Director

	
	Alta BioPharma Partners III, L.P.
		
	By:	 	Alta BioPharma Management III, LLC
		
	By:	 	 /S/ ALIX MARDUEL

		 	 Director

	
	Alta BioPharma Partners III GmbH & Co. Beteiligungs KG
		
	By:	 	Alta BioPharma Management III, LLC
		
	By:	 	 /S/ ALIX MARDUEL

		 	 Director

	
	Alta Embarcadero BioPharma Partners III, LLC
		
	By:	 	  

		 	 V.P. of Finance & Admin

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

					
	ARCH Venture Fund V, L.P.
		
	By:	 	ARCH Venture Partners V, L.P.
	Its:	 	General Partner
			
		 	By:	 	ARCH Venture Partners V, LLC
		 	Its:	 	General Partner
		
	By:	 	 /S/ CLINTON BYBEE

	Its:	 	Managing Director
	
	ARCH V Entrepreneurs Fund, L.P.
		
	By:	 	ARCH Venture Partners V, L.P.
	Its:	 	General Partner
			
		 	By:	 	ARCH Venture Partners V, LLC
		 	Its:	 	General Partner
		
	By:	 	 /S/ CLINTON BYBEE

	Its:	 	Managing Director
	
	Healthcare Focus Fund, L.P.
		
	By:	 	ARCH Venture Partners V, L.P.
	Its:	 	General Partner
			
		 	By:	 	ARCH Venture Partners V, LLC
		 	Its:	 	General Partner
		
	By:	 	 /S/ CLINTON BYBEE

	Its:	 	Managing Director

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	Montreux Equity Partners II, SBIC, L.P.
		
	By:	 	 Montreux Equity Management II SBIC,
 LLC, its General
Partner

		
	By:	 	 /S/ DANIEL K. TURNER

	Name:	 	Daniel K. Turner III
	Title:	 	Managing Member
	
	Montreux Equity Partners III, SBIC, L.P.
		
	By:	 	 Montreux Equity Management III SBIC,
 LLC, its General
Partner

		
	By:	 	 /S/ DANIEL K. TURNER

	Name:	 	Daniel K. Turner III
	Title:	 	Managing Member

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	Pacven Walden Ventures V, L.P.
		
	By:	 	  

		 	 Lip-Bu Tan

	Title:	 	 Director
 of Pacven Walden Management V,
Co.,
 Ltd. as General Partner of Pacven
 Walden Ventures V, L.P.

	
	Pacven Walden Ventures Parallel V-A, C.V.
		
	By:	 	  

		 	 Lip-Bu Tan

	Title:	 	 Director
 of Pacven Walden Management V,
Co.,
 Ltd. as General Partner of Pacven
 Walden Ventures Parallel
V-A C.V.

	
	Pacven Walden Ventures Parallel V-B, C.V.
		
	By:	 	  

		 	 Lip-Bu Tan

	Title:	 	 Director
 of Pacven Walden Management V,
Co.,
 Ltd. as General Partner of Pacven
 Walden Ventures Parallel
V-B C.V.

	
	Pacven Walden Ventures V Associates Fund, L.P.
		
	By:	 	  

	Title:	 	 Director
 of Pacven Walden Management V,
Co.,
 Ltd. as General Partner of Pacven
 Walden Ventures V
Associates Fund,
 L.P.

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

			
	Pacven Walden Ventures V-OP Associates Fund, L.P.
		
	By:	 	  

		 	 Lip-Bu Tan

	Title:	 	 Director
 of Pacven Walden Management V,
Co.,
 Ltd. as General Partner of Pacven
 Walden Ventures V-QP
Associates
 Fund, L.P.

	
	International Venture Capital Investment III Corporation
		
	By:	 	  

		 	 Lip-Bu Tan

	Title:	 	President
	
	International Venture Capital Investment Corporation
		
	By:	 	  

		 	 Lip-Bu Tan

	Title:	 	President
	
	Asian Venture Capital Investment Corporation
		
	By:	 	  

		 	 Lip-Bu Tan

	Title:	 	President
	
	Seed Ventures III Pte. Ltd.
		
	By:	 	  

		 	 Lip-Bu Tan, Director

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	Dow Employees’ Pension Plan
		
	By:	 	Diamond Capital Management Inc.
		 	Its Agent
		
	By:	 	  

	Name:	 	Kenneth J. Van Heel
	Title:	 	Sr. Investment Manager
	
	Union Carbide Employees’ Pension Plan
		
	By:	 	Diamond Capital Management Inc.
		 	Its Agent
		
	By:	 	  

	Name:	 	Kenneth J. Van Heel
	Title:	 	Sr. Investment Manager

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	 The Global Life Sciences Ventures Funds II
 GmbH & Co. KG

	
	Represented by its General Partners
	The Global Life Science Ventures GmbH
		
	By:	 	  

		
	Title:	 	  

	
	The Global Life Sciences Ventures Fund II Limited Partnership
	
	Represented by its General Partner
	Global Life Science Ventures (GP) Limited
		
	By:	 	 /S/ JO BAXTER

		
	Title:	 	 Director

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	  

	Jean-Jacques Bienaime

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	MC Life Science Ventures, Inc.
		
	By:	 	  

	Name:	 	Tsunehiko Yanagihara
	Title:	 	President

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	MunMun International Ltd.
		
	By:	 	  

		
	Name:	 	  

		
	Title:	 	  

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	Saudi Venture Development Company
		
	By:	 	  

		
	Name:	 	  

		
	Title:	 	  

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement] 

 PRIOR INVESTORS: 
  

			
	 Palefsky Children’s Irrevocable Trust fbo
 Alexis Nicole Palefsky

		
	By:	 	  

		
	Title:	 	  

	
	 Palefsky Children’s Irrevocable Trust fbo
 Nicholas Howard Palefsky

		
	By:	 	  

		
	Title:	 	  

	
	 Palefsky Children’s Irrevocable Trust fbo
 Jessica Victoria Baxter

		
	By:	 	  

		
	Title:	 	  

  

 [Signature Page to Amendment No. 1 to the Third Amended and Restated Investors’ Rights
Agreement]Form of Warrant to purchase common stock

 EXHIBIT 4.3 
 THIS WARRANT AND THE SECURITIES REPRESENTED BY THIS WARRANT HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933 (THE “ACT”) AND MAY NOT BE OFFERED, SOLD, ASSIGNED, PLEDGED, TRANSFERRED OR OTHERWISE DISPOSED OF IN THE ABSENCE
OF AN EFFECTIVE REGISTRATION STATEMENT UNDER SAID ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM REGISTRATION UNDER SAID ACT AND, IF REQUESTED BY THE COMPANY, UPON DELIVERY OF AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE COMPANY THAT THE
PROPOSED TRANSFER IS EXEMPT FROM SAID ACT. 
  

			
	 WARRANT NO.
	  	NUMBER OF SHARES:            
	 DATE OF ISSUANCE:
                    , 200    
	  	(subject to adjustment)            

 WARRANT TO PURCHASE SHARES 
 OF COMMON STOCK OF 
 NEUROGESX, INC. 
 This Warrant is issued to [            ], or its registered assigns (the
“Purchaser”), pursuant to that certain Securities Purchase Agreement, dated as of December 23, 2007, between NeurogesX, Inc. (the “Company”), the Purchaser and certain other purchasers thereunder (the
“Purchase Agreement”) and is subject to the terms and conditions of the Purchase Agreement. 
 1. EXERCISE OF WARRANT.

 (a) Method of Exercise. Subject to the terms and conditions herein set forth (including Section 1(c) below), upon surrender of
this Warrant at the principal office of the Company and upon payment of the Warrant Price (as defined below) by wire transfer to the Company or cashier’s check drawn on a United States bank made to the order of the Company, or exercise of the
right to credit the Warrant Price against the fair market value of the Warrant Stock (as defined below) at the time of exercise (the “Net Exercise Right”) pursuant to Section 1(b), Purchaser is entitled to purchase from the
Company, at any time after the date hereof and on or before the date that is five (5) years from the Date of Issuance set forth above (the “Expiration Date”), up to
[            ] shares (as adjusted from time to time pursuant to the provisions of this Warrant) of Common Stock of the Company (the “Warrant Stock”), at a purchase
price of $8.034 per share (the “Warrant Price”). 
 (b) Net Exercise Right. If the Company shall receive written
notice from the holder of this Warrant at the time of exercise of this Warrant that the holder elects to exercise the Net Exercise Right, the Company shall deliver to such holder (without payment by the Purchaser of any Warrant Price in cash) that
number of fully paid and nonassessable shares of Common Stock, par value $0.001 per share, of the Company (“Common Stock”) equal to the quotient obtained by dividing (y) the value of this Warrant (or the specified portion
thereof) on the date of exercise, which value shall be determined by subtracting (1) the aggregate Warrant Price of the Warrant Stock (or the specified portion thereof) immediately prior to the exercise of this Warrant from (2) the
Aggregate Fair Market Value (as defined below) of the Warrant Stock (or the 

 
specified portion thereof) issuable upon exercise of this Warrant (or specified portion thereof) on the date of exercise by (z) the Fair Market Value
(as defined below) of one share of Common Stock on the date of exercise. The “Fair Market Value” of a share of Common Stock shall mean the last reported sale price and, if there are no sales, the last reported bid price, of the
Common Stock on the business day prior to the date of exercise as reported by the NASDAQ Global Market or such other principal exchange or quotation system on which the Common Stock is then traded or, if the Common Stock is not publicly traded, the
price determined in good faith by the Company’s Board of Directors. The “Aggregate Fair Market Value” of the Warrant Stock shall be determined by multiplying the number of shares of Warrant Stock by the Fair Market Value of one
share of Warrant Stock. 
 (c) Percentage Limitation. The holder of this Warrant may not exercise this Warrant such that the number of
shares of Warrant Stock to be received pursuant to such exercise aggregated with all other shares of Common Stock then owned by such holder beneficially or deemed beneficially owned by such holder would result in such holder owning 20% or more of
all of such Common Stock as would be outstanding on such exercise date, as determined in accordance with Section 13(d) of the Exchange Act of 1934 and the rules and regulations promulgated thereunder; provided, however, that this
Section 1(c) shall not apply to the exercise of this Warrant in connection with an Acquisition. 
 2. CERTAIN ADJUSTMENTS. 

(a) Reorganizations. If at any time after the date hereof there shall be a capital reorganization (other than a combination or subdivision of
Warrant Stock otherwise provided for herein) (a “Reorganization”), then, as a part of such Reorganization, lawful provision shall be made so that the Purchaser shall thereafter be entitled to receive upon exercise of this Warrant,
during the period specified in this Warrant and upon payment of the Warrant Price, the number of shares of stock or other securities or property of the Company or the successor corporation resulting from such Reorganization, to which a holder of the
Common Stock deliverable upon exercise of this Warrant would have been entitled under the provisions of the agreement in such Reorganization if this Warrant had been exercised immediately before that Reorganization. In any such case, appropriate
adjustment (as determined in good faith by the Company’s Board of Directors) shall be made in the application of the provisions of this Warrant with respect to the rights and interests of the Purchaser after the Reorganization to the end that
the provisions of this Warrant (including adjustment of the Warrant Price then in effect and the number of shares of Warrant Stock) shall be applicable after that event, as near as reasonably may be, in relation to any shares or other property
deliverable after that event upon exercise of this Warrant. 
 (b) Merger. 
 (1) “Acquisition.” For the purpose of this Warrant, “Acquisition” means any sale, license, or other disposition of all
or substantially all of the assets of the Company (including a sale or license of all or substantially all of the intellectual property of the Company), or any reorganization, consolidation, acquisition or merger of the Company where the holders of
the Company’s securities before the transaction own less than 50% of the outstanding voting securities of the surviving entity after the transaction. 
  

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 (2) If at any time after the date hereof the Company proposes to consummate an Acquisition in which
(i) the shareholders of the Company shall receive cash or publicly traded securities in exchange for their shares of stock in the Company pursuant to such transaction and (ii) the aggregate value of the consideration consisting of cash
and/or publicly traded securities to be received by the Purchaser for the securities underlying this Warrant in connection with the Acquisition, as stated in the Merger Notice (defined below), does not equal or exceed the aggregate Warrant Price of
such underlying securities, then the Company shall give the holder of this Warrant written notice (the “Merger Notice”) of such impending transaction not later than ten (10) business days prior to the shareholders’ meeting called
to approve such transaction, or ten (10) business days prior to the closing of such transaction, whichever is earlier, and shall also notify the holder of this Warrant of the final approval of such transaction. The first of such notices shall
describe the material terms and conditions of the impending transaction, and the Company shall thereafter give the holder of this Warrant prompt notice of any material changes. To the extent this Warrant has not been exercised or converted in full
by the closing of such transaction then this Warrant shall automatically be deemed exercised to the fullest extent pursuant to Section 1(b) above upon the closing of such transaction, and shall otherwise terminate with respect to any shares of
Warrant Stock as to which this Warrant is not exercisable pursuant to Section 1(c) above. 
 (3) If either (x) the Company
undergoes an Acquisition in which this Warrant is not automatically exercised pursuant to the provisions of Section 2(b)(2), (a “Non-Terminating Acquisition”) or (y) upon any reorganization, consolidation, acquisition or
merger of the Company where the holders of the Company’s securities before the transaction own at least 50% of the outstanding voting securities of the surviving entity after the transaction (a “Non-Qualifying Acquisition”),
then, as a condition of such Non-Terminating Acquisition or Non-Qualifying Acquisition, as applicable, lawful provision shall be made so that the Purchaser shall thereafter be entitled to receive upon exercise of this Warrant, during the period
specified in this Warrant and upon payment of the Warrant Price, the number of shares of stock or other securities or property of the Company or the successor corporation resulting from such Non-Terminating Acquisition or Non-Qualifying Acquisition,
to which a holder of the Common Stock deliverable upon exercise of this Warrant would have been entitled under the provisions of the agreement in such Non-Terminating Acquisition or Non-Qualifying Acquisition if this Warrant had been exercised
immediately before that Non-Terminating Acquisition or Non-Qualifying Acquisition. In any such case, appropriate adjustment (as determined in good faith by the Company’s Board of Directors) shall be made in the application of the provisions of
this Warrant with respect to the rights and interests of the Purchaser after the Non-Terminating Acquisition or Non-Qualifying Acquisition to the end that the provisions of this Warrant (including adjustment of the Warrant Price then in effect and
the number of shares of Warrant Stock) shall be applicable after that event, as near as reasonably may be, in relation to any shares or other property deliverable after that event upon exercise of this Warrant. 
 (c) Splits and Subdivisions; Dividends. In the event the Company should at any time, or from time to time, fix a record date for the effectuation
of a split or subdivision of the outstanding shares of Common Stock or the determination of the holders of Common Stock entitled to receive a dividend or other distribution payable in additional shares of Common Stock or other securities or rights
convertible into, or entitling the holder thereof to receive directly or 

  

 -3- 

 
indirectly, additional shares of Common Stock (hereinafter referred to as the “Common Stock Equivalents”) without payment of any
consideration by such holder for the additional shares of Common Stock or Common Stock Equivalents (including the additional shares of Common Stock issuable upon conversion or exercise thereof), then, as of such record date (or the date of such
distribution, split or subdivision if no record date is fixed), the per share Warrant Price shall be appropriately decreased and the number of shares of Warrant Stock shall be appropriately increased in proportion to such increase (or potential
increase) of outstanding shares. 
 (d) Combination of Shares. If the number of shares of Common Stock outstanding at any time after
the date hereof is decreased by a combination of the outstanding shares of Common Stock, the per share Warrant Price shall be appropriately increased and the number of shares of Warrant Stock shall be appropriately decreased in proportion to such
decrease in outstanding shares. 
 3. NO FRACTIONAL SHARES. No fractional shares of Warrant Shares will be issued in connection with any
exercise of this Warrant. In lieu of any fractional shares which would otherwise be issuable, the Company shall pay cash equal to the product of such fraction multiplied by the Fair Market Value of one share of Warrant Stock. 
 4. NO STOCKHOLDER RIGHTS. Until the exercise of this Warrant or any portion of this Warrant, the Purchaser shall not have nor exercise any rights by
virtue hereof as a stockholder of the Company (including without limitation the right to notification of stockholder meetings or the right to receive any notice or other communication concerning the business and affairs of the Company, except as
otherwise set forth in this Warrant). 
 5. RESERVATION OF STOCK. The Company covenants that during the period this Warrant is exercisable,
the Company shall reserve from its authorized and unissued Common Stock a sufficient number of shares of Common Stock (or other securities, if applicable) to provide for the issuance of Warrant Stock (or other securities) upon the exercise of this
Warrant. The Company agrees that its issuance of this Warrant shall constitute full authority to its officers who are charged with the duty of executing stock certificates to execute and issue the necessary certificates for the Warrant Stock upon
the exercise of this Warrant. 
 6. MECHANICS OF EXERCISE. This Warrant may be exercised by the holder hereof, in whole or in part, by the
surrender of this Warrant and the Notice of Exercise attached hereto as Exhibit A duly completed and executed on behalf of the holder hereof, at the principal office of the Company together with payment in full of the Warrant Price then in
effect with respect to the number of shares of Warrant Stock as to which the Warrant is being exercised. This Warrant shall be deemed to have been exercised immediately prior to the close of business on the date of its surrender for exercise as
provided above, and the person entitled to receive the Warrant Stock issuable upon such exercise shall be treated for all purposes as the holder of such shares of record as of the close of business on such date. As promptly as practicable on or
after such date, the Company at its expense shall cause to be issued and delivered to the person or persons entitled to receive the same a certificate or certificates for the number of full shares of Warrant Stock issuable upon such exercise,
together with cash in lieu of any fraction of a share as provided above. The shares of Warrant Stock issuable upon exercise hereof shall, upon their issuance, be validly issued, fully paid and nonassessable, and free from all preemptive rights,

  

 -4- 

 
taxes, liens and charges with respect to the issue thereof. In the event that this Warrant is exercised in part, the Company at its expense will execute and
deliver a new Warrant of like tenor exercisable for the number of shares for which this Warrant may then be exercised. 
 7. CERTIFICATE OF
ADJUSTMENT. Whenever the Warrant Price or number or type of securities issuable upon exercise of this Warrant is adjusted, as herein provided, the Company shall, at its expense, promptly deliver to the record holder of this Warrant a certificate of
an officer of the Company setting forth the nature of such adjustment and showing in detail the facts upon which such adjustment is based. 
 8. TRANSFER RESTRICTIONS. The holder of this Warrant acknowledges that this Warrant and the Warrant Stock have not been registered under the Securities Act of 1933, as amended (the “Securities Act”) or applicable state
securities laws (collectively, the “Acts”), and agrees not to sell, encumber or otherwise transfer this Warrant or any Warrant Stock issued upon its exercise unless (i) there is an effective registration statement under the
Acts covering the transaction, (ii) the Company receives an opinion of counsel satisfactory to the Company that such registration is not required under the Acts, or (iii) the Company otherwise satisfies itself that registration is not
required under the Acts, it being understood that no such opinion of counsel shall be required in connection with sales pursuant to Rule 144(k) under the Act. Each certificate or other instrument for Warrant Stock issued upon the exercise of this
Warrant shall bear a legend substantially to the foregoing effect. 
 9. NOTICES OF RECORD DATE. In the event of: 
 (a) any taking by the Company of a record of the holders of any class of securities for the purpose of determining the holders thereof who are entitled to
receive any dividend (other than a cash dividend payable out of earned surplus of the Company) or other distribution, or any right to subscribe for, purchase or otherwise acquire any shares of stock of any class or any other securities or property,
or to receive any other right; or 
 (b) any Reorganization; or 
 (c) any voluntary or involuntary dissolution, liquidation or winding-up of the Company, 
 then and in each such event the Company will mail or cause to be mailed to the Purchaser (or a permitted transferee pursuant to Section 9(b) above) a notice specifying (i) the date on which any such record
is to be taken for the purpose of such dividend, distribution or right, and stating the amount and character of such dividend, distribution or right, and (ii) the date on which any such Reorganization, dissolution, liquidation or winding-up is
to take place, and the time, if any, as of which the holders of record of Common Stock (or other securities) shall be entitled to exchange their shares of Common Stock (or other securities) for securities or other property deliverable upon such
Reorganization, dissolution, liquidation or winding-up. Such notice shall be mailed at least ten (10) business days prior to the date therein specified. 
  

 -5- 

 10. REPLACEMENT OF WARRANTS. On receipt of evidence reasonably satisfactory to the Company of the loss,
theft, destruction or mutilation of this Warrant and, in the case of any such loss, theft, destruction or mutilation of this Warrant, on delivery of an indemnity agreement or security reasonably satisfactory in form and amount to the Company or, in
the case of any such mutilation, on surrender and cancellation of such Warrant, the Company at its expense will execute and deliver, in lieu thereof, a new Warrant of like tenor. 
 11. SATURDAYS, SUNDAYS, HOLIDAYS, ETC. If the last or appointed day for the taking of any action or the expiration of any right required or granted
herein shall be a Saturday or Sunday or shall be a legal U.S. holiday, then such action may be taken or such right may be exercised on the next succeeding day not a Saturday, Sunday or legal U.S. holiday. 
 12. MISCELLANEOUS. This Warrant shall be governed by the laws of the State of California. The headings in this Warrant are for purposes of convenience
and reference only, and shall not be deemed to constitute a part hereof. Neither this Warrant nor any term hereof may be changed, waived, discharged or terminated orally but only by an instrument in writing signed by the Company and the Purchaser.
All notices and other communications from the Company to the Purchaser shall be sufficient if in writing and delivered (i) personally, (ii) by facsimile transmission (receipt verified), (iii) by registered or certified mail (return
receipt requested), postage prepaid, or (iv) sent by express courier service (receipt verified), to the address furnished to the Company in writing by the Purchaser. All such notices and communications to the Company shall be effective if
delivered (i) personally, (ii) by facsimile transmission (receipt verified), (iii) by registered or certified mail (return receipt requested), postage prepaid, or (iv) sent by express courier service (receipt verified), at
NeurogesX, Inc., Attention: Anthony DiTonno, President & Chief Executive Officer, 2215 Bridgepointe Parkway, Suite 200, San Mateo, California 94404, fax: 650-412-1999, with a copy to Wilson Sonsini Goodrich & Rosati, Professional
Corporation, Attention: Michael J. O’Donnell, Esq., 650 Page Mill Road, Palo Alto, California 94304, fax: 650-493-6811. The invalidity or unenforceability of any provision hereof shall in no way affect the validity or enforceability of any
other provisions. 
 [Signature Page Follows] 
  

 -6- 

 IN WITNESS WHEREOF, this Warrant to Purchase Shares of Common Stock is issued effective as of the Date of
Issuance first set forth above. 
  

			
	NEUROGESX, INC.
		
	By:	 	  

	Name:	 	Anthony DiTonno
	Title:	 	President & Chief Executive Officer

 EXHIBIT A 
 NOTICE OF INTENT TO EXERCISE 
 (To be signed only upon exercise of Warrant) 
  

			
	To:	 	NeurogesX, Inc.

 The undersigned, the Purchaser of the attached Warrant, hereby irrevocably elects to exercise the
purchase right represented by such Warrant for, and to purchase thereunder,
                    (            ) shares of Common Stock of NeurogesX,
Inc. and (choose one) 
                      herewith makes payment of
                         Dollars
($                    ) thereof 
 or 
  

			
	                      exercises the Net
Exercise Right pursuant to Section 1(b) thereof and requests that the certificates for such shares be issued in the name of, and delivered to
                                        
                    , whose address is

		
	 	 	 
	                                       
                      .

  

			
	DATED:
                                        
	 	
		 	(Signature must conform in all
		 	respects to name of the Purchaser
		 	as specified on the face of the
		 	Warrant)
		
		 	  

		 	  

		 	(Address)

 EXHIBIT B 
 NOTICE OF ASSIGNMENT FORM 
                                       
   (the “Assignor”) hereby transfers, without consideration, all of the rights of the undersigned Assignor under the attached Warrant with respect to the number of shares of common stock of NeurogesX, Inc. (the
“Company”) covered thereby set forth below, to the following “Assignee”: 
  

							
	 NAME OF ASSIGNEE
	 	 ADDRESS/FAX NUMBER

				
	Dated:	 	  
	 	Signature:	 	  

				
		 		 	Witness:

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