What Tenax Therapeutics does

Tenax Therapeutics is a Phase 3 development-stage specialty pharmaceutical company headquartered in Chapel Hill, North Carolina, publicly traded on NASDAQ under the ticker TENX. The company is singularly focused on developing treatments for cardiopulmonary diseases, with its lead and only clinical asset being TNX-103, an oral formulation of levosimendan, being advanced for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF) — a debilitating, often fatal condition affecting an estimated 2.1 million Americans for which there are currently no approved treatments. TNX-103 works through a novel mechanism: as a first-in-class potassium-ATP channel activator and calcium sensitizer, it produces a potent and specific dilatory effect on the splanchnic (abdominal) venous circulation, thereby reducing elevated venous blood volume and lowering pulmonary capillary wedge pressure (PCWP), the hemodynamic hallmark of PH-HFpEF. Levosimendan itself is authorized in its intravenous form in 60 countries for acute decompensated heart failure (ADHF), providing Tenax with a substantial pre-existing safety database spanning more than two decades of clinical use that materially derisks the Phase 3 program.

The company's clinical program consists of two Phase 3 trials: the LEVEL trial, a 12-week randomized study conducted in the U.S. and Canada, which completed randomization of 230 patients in March 2026 with topline data expected in Q3 2026; and the LEVEL-2 trial, a 26-week global Phase 3 study initiated in 2026 with enrollment targeted to complete by year-end 2027 and topline data anticipated in H2 2028. TNX-103 is reported as the only drug candidate to demonstrate exercise improvement (via six-minute walk test) and profound improvements in exercise hemodynamics in PH-HFpEF patients, and the company holds a U.S. patent covering levosimendan's use in this indication.

As a pre-commercial clinical-stage company, Tenax generates no product revenue and its business model is entirely reliant on equity capital markets to fund R&D and operating expenses. The company has no pricing model, no distribution channels, and no commercial customers; it has explicitly disclosed no commercial revenue. Operations are funded through a series of equity financings including an $8M PIPE (May 2022), a $15.6M public offering (February 2023), a $9.04M public offering (February 2024), a $100M oversubscribed private placement led by BVF Partners LP (August 2024), and a $25M private placement with RTW Investments (March 2025). The company reported a $52.6M net loss for 2025, with stated cash runway expected to fund operations through 2027. Leadership is concentrated among experienced pharmaceutical executives, including CEO Chris Giordano (formerly President of IQVIA Biotech), CMO Dr. Stuart Rich (Professor Emeritus of Medicine at Northwestern), and recent C-suite additions Thomas Staab (CFO, effective May 2026) and Timothy Healey (CCO, May 2026) signaling pre-launch commercial buildout.

Name

Tenax Therapeutics

Legal name

Tenax Therapeutics, Inc.

Website

https://tenaxthera.com

Company type

Public

Founded year

1967

Operating status

Operating

Headcount range

11–50 employees

Short description

Tenax Therapeutics is a Phase 3 clinical-stage pharmaceutical company developing TNX-103, an oral formulation of levosimendan, as a potential first treatment for pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF), addressing roughly 2.1 million U.S. patients with no approved therapies.

Ownership category

akta.pro rank

Product category

Cardiopulmonary Specialty Pharmaceuticals

NAICS

Scientific Research and Development Services (5417)

SIC

Pharmaceutical Preparations (2834)

akta.pro primary industry

Pulmonary Hypertension & Rare Pulmonary Disease Therapies (HLAIAIAG)

akta.pro secondary industry

Rare Cardiovascular & Vascular Disorder Therapies (HLAIAIAH)

Keywords

• Pulmonary hypertension therapeutics
• Cardiopulmonary drug development
• Heart failure treatments
• Clinical stage biopharmaceuticals
• Potassium channel activators

Headquarters

HQ city

Chapel Hill

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Hardware or Manufacturing

Cost components

Technology or R&D, Personnel, Operations, Marketing or Sales

Marketing channels3 records

Core offering

Tenax Therapeutics is developing TNX-103, an oral formulation of levosimendan, as a first-in-class treatment for pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF). The drug works as a potassium-ATP channel activator and calcium sensitizer, targeting the splanchnic venous circulation to reduce elevated pulmonary capillary wedge pressure. The company is currently executing a Phase 3 registrational program consisting of the LEVEL and LEVEL-2 clinical trials, with no products approved or commercialized to date.

Product overview

Tenax Therapeutics is a Phase 3 development-stage pharmaceutical company with a single focused product candidate: TNX-103, an oral formulation of levosimendan. The company is executing a derisked Phase 3 registrational program consisting of the LEVEL trial (12-week, randomized, Canada & U.S.) and the subsequent LEVEL-2 trial (26-week global study). The product candidate addresses a significant unmet medical need for PH-HFpEF, for which there are no approved treatments. The drug candidate's development is supported by established safety data from over two decades of clinical use of intravenous levosimendan in acute heart failure settings.

Differentiator

Problem solved

Functional benefit

Products and services

• TNX-103 (Oral Levosimendan) TNX-103 is an oral formulation of levosimendan, a first-in-class potassium-ATP channel activator and calcium sensitizer, being developed for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction (PH-HFpEF). It works by targeting the splanchnic venous circulation to lower elevated pulmonary capillary wedge pressure. Levosimendan is currently authorized for use in 60 countries in its intravenous form for acute decompensated heart failure. The product is intended for PH-HFpEF patients — a population of over 2.1 million in the United States with no approved treatment options.

Quantifiable outcome

• Only drug to show exercise improvement (6-minute walk test) in PH-HFpEF patients with profound improvements in exercise hemodynamics
• +2 more outcomes

Segments1 record

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Scale indicators7 records

Recent moves6 records

Expansion highlights5 records

Emerging players

• BridgeBio Pharma: Clinical-stage rare disease biotech with cardiovascular programs (e.g., acoramidis for transthyretin amyloid cardiomyopathy); comparable as a similarly structured late-stage biotech with single-asset concentration and capital-intensive development model.
• Lexicon Pharmaceuticals: Small-cap clinical-stage company focused on cardiovascular and metabolic diseases; comparable as a similarly-sized peer pursuing novel mechanisms in cardiopulmonary indications with similar resource constraints.
• Gossamer Bio: Clinical-stage biopharma developing seralutinib (inhaled PDGFR inhibitor) for PAH — directly comparable late-stage pulmonary hypertension program with novel mechanism targeting similar patient population.

Broad incumbents

• Pfizer: Major cardiovascular pharma with sildenafil (Revatio) approved for PAH and broad cardiopulmonary R&D; comparable as a potential strategic acquirer for TNX-103 given large-pharma infrastructure in cardiovascular drug commercialization.
• Bayer AG: Markets riociguat (Adempas), the only approved therapy for chronic thromboembolic pulmonary hypertension (CTEPH), and has broad cardiovascular/pulmonary franchise. Comparable given established PH commercial presence and large-pharma cardiovascular R&D.
• Insmed: Commercial-stage respiratory biopharma with ARIKAYCE for lung infections and a growing pipeline in serious lung diseases including PH. Comparable given its focus on inhaled therapies for cardiopulmonary indications and larger commercial reach.
• Merck & Co. (Acceleron acquisition): Acquired Acceleron Pharma in 2021 for sotatercept (Winrevair), now approved for PAH — the most significant new PH therapy launch in years and a key benchmark for the commercial potential of PH-HFpEF therapies.

Direct peers

• Aerovate Therapeutics: Late-stage clinical company developing inhaled imatinib for pulmonary arterial hypertension (PAH), a direct competitor targeting the same PH disease space with a different mechanism; both companies are pursuing first-in-class oral/inhaled therapies for underserved PH indications.
• Liquidia Corporation: Commercial-stage PH company (YUTREPIA, inhaled treprostinil) targeting pulmonary hypertension and pulmonary-interstitial lung disease. Comparable business model focused on reformulated/improved delivery of established PH therapies.
• United Therapeutics: Established pulmonary hypertension leader with approved PH therapies (Remodulin, Tyvaso, Orenitram) including inhaled treprostinil for PH-ILD. Most directly comparable to Tenax given overlapping PH indication, and Tenax CMO Stuart Rich previously served as part-time CMO of United Therapeutics.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/tenax-therapeutics
• Xx.com/TenaxThera

Revenue estimate

Valuation estimate

Number of profiles

Profiles14 records

Funding overview

Funding rounds12 records

Investors10 records

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M&A1 record

Investments1 record

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Tenax Therapeutics