Stuart Rich - 02 Dec 2025 Form 4 Insider Report for TENAX THERAPEUTICS, INC. (TENX)

Role: Chief Medical Officer, Director
Signature: /s/ S. Halle Vakani, as Attorney-in-Fact
Issuer symbol: TENX
Transactions as of: 02 Dec 2025
Net transactions value: +$45,622
Form type: 4
Filing time: 05 Dec 2025, 17:46:32 UTC
Previous filing: 20 May 2025
Next filing: 10 Dec 2025
SEC: View on sec.gov

Reporting Owners (1)

Name	Relationship	Address	Signature	Signature date	CIK
Rich Stuart	Chief Medical Officer, Director	101 GLEN LENNOX DRIVE, SUITE 300, CHAPEL HILL	/s/ S. Halle Vakani, as Attorney-in-Fact	05 Dec 2025	0001841785

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	TENX	Common Stock	Purchase	$9,006	+1,000	+376%	$9.01	1,266	02 Dec 2025	Direct	F1
transaction	TENX	Common Stock	Purchase	$13,618	+1,500	+118%	$9.08	2,766	03 Dec 2025	Direct	F2
transaction	TENX	Common Stock	Purchase	$22,998	+2,500		$9.20	2,500	04 Dec 2025	By Stuart Rich Revocable Trust DTD 11/18/1996	F3, F4
holding	TENX	Common Stock						1,194	02 Dec 2025	By Stuart Rich 2022 Irrevocable Trust	F5
holding	TENX	Common Stock						1,194	02 Dec 2025	By Andrea Rich 2021 Irrevocable Trust	F6

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
holding	TENX	Stock Option (right to buy)						157	02 Dec 2025	Common Stock	157	$2848.00	Direct	F7
holding	TENX	Stock Option (right to buy)						63	02 Dec 2025	Common Stock	63	$992.00	Direct	F8
holding	TENX	Stock Option (right to buy)						119	02 Dec 2025	Common Stock	119	$3.55	Direct	F9
holding	TENX	Stock Option (right to buy)						500,000	02 Dec 2025	Common Stock	500,000	$5.94	Direct
holding	TENX	Stock Option (right to buy)						625,000	02 Dec 2025	Common Stock	625,000	$5.89	Direct	F10

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	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.
F2	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.
F3	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.
F4	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.
F5	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.
F6	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.
F7	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.
F8	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.
F9	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.
F10	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.