X0508 4 2025-12-02 0 0000034956 TENAX THERAPEUTICS, INC. TENX 0001841785 Rich Stuart 101 GLEN LENNOX DRIVE, SUITE 300 CHAPEL HILL NC 27517 1 1 0 0 Chief Medical Officer 0 Common Stock 2025-12-02 4 P 0 1000 9.0059 A 1266 D Common Stock 2025-12-03 4 P 0 1500 9.0786 A 2766 D Common Stock 2025-12-04 4 P 0 2500 9.1992 A 2500 I By Stuart Rich Revocable Trust DTD 11/18/1996 Common Stock 1194 I By Stuart Rich 2022 Irrevocable Trust Common Stock 1194 I By Andrea Rich 2021 Irrevocable Trust Stock Option (right to buy) 2848 2031-01-15 Common Stock 157 157 D Stock Option (right to buy) 992 2032-06-09 Common Stock 63 63 D Stock Option (right to buy) 3.549 2034-05-17 Common Stock 119 119 D Stock Option (right to buy) 5.94 2025-12-10 2034-12-10 Common Stock 500000 500000 D Stock Option (right to buy) 5.89 2035-05-16 Common Stock 625000 625000 D This transaction was executed in multiple trades at prices ranging from $8.89 to $9.06. The price reported in Column 4 is a weighted average price. The Reporting Person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transactions were effected. This transaction was executed in multiple trades at prices ranging from $8.88 to $9.22. The price reported in Column 4 is a weighted average price. The Reporting Person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transactions were effected. This transaction was executed in multiple trades at prices ranging from $9.00 to $9.46. The price reported in Column 4 is a weighted average price. The Reporting Person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transactions were effected. The Reporting Person is trustee of the Stuart Rich Revocable Trust DTD 11/18/1996 and disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The Reporting Person is special asset advisor to the Stuart Rich 2022 Irrevocable Trust, a Spousal Lifetime Access Trust (the "Trust"). As such, the Reporting Person has voting and dispositive power over the reported securities held in the Trust, however disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. The Reporting Person is co-trustee of the Andrea Rich 2021 Irrevocable Trust and disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The options vest and become exercisable in four equal installments, with 25% vesting after the start of a Phase 3 clinical trial, 25% vesting after the database lock with respect to the trial, 25% vesting after the opening of an Investigational New Drug Application with the U.S. Food and Drug Administration ("FDA"), and 25% vesting after the approval from the FDA, subject to the Reporting Person's continued employment. The options vest and become exercisable as follows: 25% of the underlying shares of common stock vest and become exercisable on each of June 9, 2023, June 9, 2024, June 9, 2025, and June 9, 2026, subject to the Reporting Person's continued employment. The options vest and become exercisable as follows: 25% of the underlying shares of common stock vest and become exercisable on each of May 17, 2025, May 17, 2026, May 17, 2027, and May 17, 2028, subject to the Reporting Person's continued employment. The options vest and become exercisable as follows: 25% of the underlying shares of common stock vest and become exercisable on May 16, 2026, and thereafter 1/36th of the remaining shares will vest on the last day of each following month for a period of 36 months, subject to the Reporting Person's continued employment. /s/ S. Halle Vakani, as Attorney-in-Fact 2025-12-05