CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT MATERIAL AND (II) IS THE TYPE THAT REGISTRANT TREATS AS PRIVATE OR CONFIDENTIAL Execution Version 1634107873.7 SECOND AMENDMENT TO LOAN AND SECURITY AGREEMENT THIS SECOND AMENDMENT TO LOAN AND SECURITY AGREEMENT (this “Amendment”), dated as of August 3, 2026, is entered into by and among MOONLAKE IMMUNOTHERAPEUTICS, an exempted company incorporated in the Cayman Islands with limited liability (“Parent”), its Subsidiary, MOONLAKE IMMUNOTHERAPEUTICS AG, a joint-stock corporation established under the laws of Switzerland with its registered address at Dorfstrasse 29, 6300 Zug, Switzerland, and registered with the commercial register of the canton of Zug under registration number CHE-433.093.536 (“Borrower”), MOONLAKE IMMUNOTHERAPEUTICS LTD, a private company incorporated in England and Wales with company number 13502700 (“MoonLake UK”), MOONLAKE IMMUNOTHERAPEUTICS US INC., a Delaware corporation (“MoonLake US”) and each other Person that has delivered a Joinder Agreement pursuant to Section 7.13 from time to time party thereto (together with Borrower, MoonLake UK, Parent and each other Person that has delivered a Joinder Agreement pursuant to Section 7.13, collectively, the “Loan Parties”), the several financial institutions or entities from time to time party to the Loan Agreement (each, a “Lender”, and collectively “Lenders”) and HERCULES CAPITAL, INC., a Maryland corporation, in its capacity as administrative agent and collateral agent for itself and Lenders (in such capacity, including any successors or assigns, “Agent”). (a) The Loan Parties, Lenders and Agent are parties to that certain Loan and Security Agreement, dated as of March 31, 2025 (as amended, restated, amended and restated, supplemented or otherwise modified from time to time prior to the date of this Amendment, the “Loan Agreement”). Lender has extended credit to Borrower for the purposes permitted in the Loan Agreement. (b) The Loan Parties, Agent and Lender have agreed to certain amendments to the Loan Agreement upon the terms and conditions more fully set forth herein. SECTION 1 Definitions; Interpretation. (a) Terms Defined in Loan Agreement. All capitalized terms used in this Amendment (including in the recitals hereof) and not otherwise defined herein shall have the meanings assigned to them in the Loan Agreement (as amended by this Amendment). (b) Rules of Construction. The rules of construction in Section 1.3 of the Loan Agreement shall be applicable to this Amendment and are incorporated herein by this reference. SECTION 2 Amendments to the Loan Agreement. (a) The Loan Agreement shall be amended as follows effective as of the Second Amendment Effective Date: (i) The following defined term shall be added to Section 1.1 of the Loan Agreement as follows: “US Chief Executive Office” means [***], USA. (ii) Clause (vii) of the definition of “Permitted Indebtedness” is hereby amended and restated in its entirety as follows: (vii) reimbursement obligations in connection with letters of credit that are at any time outstanding and secured by Cash and issued on behalf of Parent,
2 1634107873.7 Borrower or a Subsidiary in an amount not to exceed Three Million Dollars ($3,000,000) in the aggregate; (iii) Clause (xv) of the definition of “Permitted Liens” is hereby amended and restated in its entirety as follows: (xv) (a) security deposits in connection with real property leases in an aggregate amount not to exceed Two Hundred Fifty Thousand Dollars ($250,000) at any time and (b) Liens securing obligations permitted under clause (vii) of the definition of Permitted Indebtedness; (iv) The definition of “Excluded Accounts” is hereby amended and restated in its entirety as follows: “Excluded Accounts” means any of the following Deposit Accounts or securities accounts which are designated as such in writing to Agent as of the Closing Date or, with respect to any Deposit Account or securities account opened after the Closing Date, in the next Compliance Certificate delivered after such Deposit Account or securities account is opened: (a) Deposit Accounts and securities accounts exclusively used for payroll, payroll taxes, and other employee wage and benefit payments to or for the benefit of Borrower’s employees holding an aggregate amount across all such accounts of not more than amounts needed for the then-next three (3) payroll cycles, (b) any Deposit Account or securities account which is a zero-balance disbursement account, (c) any Deposit Account or securities account which is solely used for disbursements and payments of withheld income taxes, payroll taxes and/or federal, state or local employee taxes, (d) any Deposit Account or securities account which is solely used as a trust account, escrow account, or other fiduciary account, or (e) any Deposit Account or securities account which is subject to a Permitted Lien under clause (xv) of the definition thereof. (v) Section 7.11(d) of the Loan Agreement is hereby amended and restated in its entirety as follows: (d) If any Loan Party intends to add any new offices or business locations in the United States, including warehouses, containing any portion of such Loan Party’s assets or property valued, individually or in the aggregate, in excess of (i) One Million Dollars ($1,000,000), in the case of any such office or business location other than the US Chief Executive Office, or (ii) Three Million Five Hundred Thousand Dollars ($3,500,000), in the case of the US Chief Executive Office, then such Loan Party will use commercially reasonable efforts to cause the landlord of any such new office or business location, including any warehouse, to execute and deliver a landlord consent in form and substance satisfactory to Agent. (b) References Within Loan Agreement. Each reference in the Loan Agreement to “this Agreement” and the words “hereof,” “herein,” “hereunder,” or words of like import, shall mean and be a reference to the Loan Agreement as amended by this Amendment. SECTION 3 Conditions of Effectiveness. The effectiveness of this Amendment (the “Second Amendment Effective Date”) shall be subject to Agent’s receipt of the following documents, in form and substance satisfactory to Agent, or, as applicable, the following conditions being met: (a) this Amendment, executed by Agent, Lender and the Loan Parties;
3 1634107873.7 (b) the Loan Parties shall have paid (i) all invoiced costs and expenses then due in accordance with Section 6(d), and (ii) all other fees, costs and expenses, if any, due and payable as of the date hereof under the Loan Agreement; (c) on the Second Amendment Effective Date, immediately after giving effect to the amendments of the Loan Agreement contemplated hereby: (i) the representations and warranties contained in Section 4 shall be true and correct in all material respects on and as of the Second Amendment Effective Date as though made on and as of such date; provided, however, that such materiality qualifier shall not be applicable to any representations and warranties that already are qualified or modified by materiality in the text thereof; provided, further, that to the extent such representations and warranties by their terms expressly relate only to a prior date such representations and warranties shall be true and correct as of such prior date; and (ii) there exist no Defaults or Events of Default. SECTION 4 Representations and Warranties. To induce Agent and Lender to enter into this Amendment, each Loan Party hereby confirms, as of the date hereof, (a) that the representations and warranties made by it in Section 5 of the Loan Agreement and in the other Loan Documents are true and correct in all material respects; provided, however, that such materiality qualifier shall not be applicable to any representations and warranties that already are qualified or modified by materiality in the text thereof; provided, further, that to the extent such representations and warranties by their terms expressly relate only to a prior date such representations and warranties shall be true and correct as of such prior date; (b) that no Event of Default has occurred and is continuing; (c) [reserved]; (d) Lender has and shall continue to have valid, enforceable and perfected first-priority liens, subject only to Permitted Liens, on and security interests in the Collateral and all other collateral heretofore granted by each Loan Party to Lender, pursuant to the Loan Documents or otherwise granted to or held by Lender; (e) the agreements and obligations of each Loan Party contained in the Loan Documents and in this Amendment constitute the legal, valid and binding obligations of such Loan Party, enforceable against such Loan Party in accordance with their respective terms, except as the enforceability thereof may be limited by bankruptcy, insolvency or other similar laws of general application affecting the enforcement of creditors’ rights or by the application of general principles of equity; and (f) the execution, delivery and performance of this Amendment by the Loan Parties will not violate (1) any organizational document of any Loan Party, (2) any material law, rule, regulation or order to which such Loan Party is subject, or (3) except as described on Schedule 5.3 to the Loan Agreement, any contractual obligation of any Loan Party which has not already been obtained and that could reasonably be expected to have a Material Adverse Effect and will not result in, or require, the creation or imposition of any lien, claim or encumbrance of any kind on any of its properties or revenues, other than Permitted Liens and the Liens created by the Loan Agreement and the other Loan Documents. For the purposes of this Section 4, each reference in Section 5 of the Loan Agreement to “this Agreement”, and the words “hereof”, “herein”, “hereunder”, or words of like import in such Section, shall mean and be a reference to the Loan Agreement as amended by this Amendment. SECTION 5 Release. In consideration of the agreements of Agent and each Lender contained herein and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, each Loan Party, on behalf of itself and its successors, assigns, and other legal representatives, hereby to the extent possible under applicable law and only to the extent relating to facts, actions or omissions existing on or prior to the date of this Amendment, fully, absolutely, unconditionally and irrevocably releases, remises and forever
4 1634107873.7 discharges Agent and each Lender, in each case solely in their capacities as such, and its successors and assigns, and its present and former shareholders, affiliates, subsidiaries, divisions, predecessors, directors, officers, attorneys, employees, agents and other representatives (Agent, Lender and all such other persons being hereinafter referred to collectively as the “Releasees” and individually as a “Releasee”), of and from all demands, actions, causes of action, suits, covenants, contracts, controversies, agreements, promises, sums of money, accounts, bills, reckonings, damages and any and all other claims, counterclaims, defenses, rights of set-off, demands and liabilities whatsoever of every name and nature, known or unknown, suspected or unsuspected, both at law and in equity, which each Loan Party, or any of its successors, assigns, or other legal representatives may now or hereafter own, hold, have or claim to have against the Releasees or any of them for, upon, or by reason of any circumstance, action, cause or thing whatsoever which arises at any time on or prior to the day and date of this Amendment, for or on account of, or in relation to, or in any way in connection with the Loan Agreement, or any of the other Loan Documents or transactions thereunder or related thereto provided, however, that the foregoing release shall not apply to any claims to the extent arising from the willful misconduct or gross negligence of any Releasee. Each Loan Party understands, acknowledges and agrees that the release set forth above may be pleaded as a full and complete defense and may be used as a basis for an injunction against any action, suit or other proceeding which may be instituted, prosecuted or attempted in breach of the provisions of such release. Each Loan Party agrees that no fact, event, circumstance, evidence or transaction which could now be asserted or which may hereafter be discovered shall affect in any manner the final, absolute and unconditional nature of the release set forth above. SECTION 6 Miscellaneous. (a) Loan Documents Otherwise Not Affected; Reaffirmation; No Novation. (i) Except as expressly amended pursuant hereto or referenced herein, the Loan Agreement and the other Loan Documents shall remain unchanged and in full force and effect and are hereby ratified and confirmed in all respects. The Lender’s and Agent’s execution and delivery of, or acceptance of, this Amendment shall not be deemed to create a course of dealing or otherwise create any express or implied duty by any of them to provide any other or further amendments, consents or waivers in the future. (ii) Each Loan Party hereby expressly (1) reaffirms, ratifies and confirms its Secured Obligations under the Loan Agreement and the other Loan Documents, (2) reaffirms, ratifies and confirms the grant of security under Section 3 of the Loan Agreement and the Swiss Security Documents, (3) reaffirms that such grant of security in the Collateral secures all Secured Obligations under the Loan Agreement, including without limitation any Term Loan Advances funded on or after the Second Amendment Effective Date, as of the date hereof, and with effect from (and including) the Second Amendment Effective Date, such grant of security in the Collateral: (x) remains in full force and effect notwithstanding the amendments expressly referenced herein; and (y) secures all Secured Obligations under the Loan Agreement, as amended by this Amendment and the other Loan Documents, (4) agrees that this Amendment shall be a “Loan Document” under the Loan Agreement, and (5) agrees that the Loan Agreement and each other Loan Document shall remain in full force and effect following any action contemplated in connection herewith. (iii) This Amendment is not a novation and the terms and conditions of this Amendment shall be in addition to and supplemental to all terms and conditions set forth in the Loan Documents. Nothing in this Amendment is intended, or shall be construed, to constitute an accord and satisfaction of any Loan Party’s Secured Obligations under or in connection with the Loan Agreement and any other Loan Document or to modify, affect or impair the perfection or continuity of Agent’s security
5 1634107873.7 interest in, (on behalf of itself and the Lender) security titles to or other liens on any Collateral for the Secured Obligations. (b) Conditions. For purposes of determining compliance with the conditions specified in Section 3, each Lender that has signed this Amendment shall be deemed to have consented to, approved or accepted or to be satisfied with, each document or other matter required thereunder to be consented to or approved by or acceptable or satisfactory to the Lender unless Agent shall have received notice from such Lender prior to the date hereof specifying its objection thereto. (c) No Reliance. Each Loan Party hereby acknowledges and confirms to Agent and Lender that each Loan Party is executing this Amendment on the basis of its own investigation and for its own reasons without reliance upon any agreement, representation, understanding or communication by or on behalf of any other Person. (d) Costs and Expenses. The Loan Parties agree to pay to Agent on the date hereof the reasonable and documented out-of-pocket costs and expenses of Agent and each Lender party hereto, and the fees and disbursements of counsel to Agent and each Lender party hereto (excluding allocated costs of internal counsel) in connection with the negotiation, preparation, execution and delivery of this Amendment and any other documents to be delivered in connection herewith on the date hereof. (e) Binding Effect. This Amendment binds and is for the benefit of the successors and permitted assigns of each party. (f) Governing Law. THIS AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED AND ENFORCED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK, EXCLUDING CONFLICT OF LAWS PRINCIPLES THAT WOULD CAUSE THE APPLICATION OF LAWS OF ANY OTHER JURISDICTION. (g) Complete Agreement; Amendments. This Amendment and the Loan Documents represent the entire agreement about this subject matter and supersede prior negotiations or agreements with respect to such subject matter. All prior agreements, understandings, representations, warranties, and negotiations between the parties about the subject matter of this Amendment and the Loan Documents merge into this Amendment and the Loan Documents. (h) Severability of Provisions. Each provision of this Amendment is severable from every other provision in determining the enforceability of any provision. (i) Counterparts. This Amendment may be executed in any number of counterparts and by different parties on separate counterparts, each of which, when executed and delivered, is an original, and all taken together, constitute one Amendment. Delivery of an executed counterpart of a signature page of this Amendment by facsimile, portable document format (.pdf) or other electronic transmission will be as effective as delivery of a manually executed counterpart hereof. (j) Electronic Execution of Certain Other Documents. The words “execution,” “execute”, “signed,” “signature,” and words of like import in or related to any document to be signed in connection with this Agreement and the transactions contemplated hereby (including without limitation assignments, assumptions, amendments, waivers and consents) shall be deemed to include electronic signatures, the electronic matching of assignment terms and contract formations on electronic platforms approved by Agent, or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or enforceability as a manually executed signature or the use of a paper-based recordkeeping system, as the case may be, to the extent and as provided for in any applicable law, including the Federal Electronic
6 1634107873.7 Signatures in Global and National Commerce 68 Act, the New York Uniform Electronic Transactions Act, or any other similar state laws based on the Uniform Electronic Transactions Act. [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]
[Signature Page to Second Amendment] 1634107873.7 IN WITNESS WHEREOF, the parties hereto have duly executed this Amendment, as of the date first above written. BORROWER: MOONLAKE IMMUNOTHERAPEUTICS AG Signature: (signed) /s/ Matthias Bodenstedt Print Name: Matthias Bodenstedt Title: Chief Financial Officer MOONLAKE IMMUNOTHERAPEUTICS US INC. Signature: (signed) /s/ Matthias Bodenstedt Print Name: Matthias Bodenstedt Title: Chief Financial Officer GUARANTORS: MOONLAKE IMMUNOTHERAPEUTICS Executed as a Deed Signature: (signed) /s/ Matthias Bodenstedt Print Name: Matthias Bodenstedt Title: Chief Financial Officer MOONLAKE IMMUNOTHERAPEUTICS LTD Signature: (signed) /s/ Matthias Bodenstedt Print Name: Matthias Bodenstedt Title: Director
[Signature Page to Second Amendment] 1634107873.7 AGENT: HERCULES CAPITAL, INC. Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: President
[Signature Page to Second Amendment] 1634107873.7 LENDERS: HERCULES CAPITAL, INC. Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: President HERCULES PRIVATE CREDIT FUND 1 L.P. By: Hercules Adviser LLC, its Investment Adviser Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: Authorized Signatory HERCULES PRIVATE FUND ONE LLC By: Hercules Adviser LLC, its Investment Adviser Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: Authorized Signatory HERCULES PRIVATE GLOBAL VENTURE GROWTH FUND I L.P. By: Hercules Adviser LLC, its Investment Adviser Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: Authorized Signatory
[Signature Page to Second Amendment] 1634107873.7 HERCULES PRIVATE CREDIT FINANCING SPV, LLC By: Hercules Private Credit Fund Holdings, LLC, its Sole Member By: Hercules Adviser LLC, its Manager Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: Authorized Signatory HERCULES GROWTH LENDING FUND IV LP By: Hercules Growth Lending Fund IV GP LLC, its General Partner Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: Authorized Signatory HERCULES EVERGREEN FUND LP By: Hercules Evergreen Fund GP LLC, its General Partner Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: Authorized Signatory
[Signature Page to Second Amendment] 1634107873.7 HERCULES EVERGREEN SPV LLC By: Hercules Evergreen Fund LP By: Hercules Evergreen Fund GP LLC By: Hercules Partner Holdings, LLC, its Sole Member By: Hercules Capital Management LLC, its Sole Member Signature: (signed) /s/ Seth Meyer Print Name: Seth Meyer Title: Authorized Signatory