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These shares were sold in multiple transactions at prices ranging from $74.98 to $75.51 inclusive.  The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (2) on this Form 4."}],"balance_after":62211,"source":{"system":"sec-edgar","filing":"0000874015-26-000144","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":1,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401526000144/edgardoc.xml","form_type":"4"}},{"id":871250,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2026-03-03T22:29:07.000Z","date":"2026-02-27","kind":"other","planned":false,"acquired":true,"shares":376,"price":48.8665,"value":18373.804,"ownership":{"direct":true},"footnotes":[{"field":"shares","element":"transactionShares","label":"F1","text":"Reporting shares purchased under the Ionis Pharmaceuticals, Inc. 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These shares were sold in multiple transactions at prices ranging from $83.48 to $83.67 inclusive.  The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (2) on this Form 4."}],"balance_after":71983,"source":{"system":"sec-edgar","filing":"0000874015-26-000100","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":2,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401526000100/edgardoc.xml","form_type":"4"}},{"id":926040,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2026-02-03T01:51:59.000Z","date":"2026-01-29","kind":"grant","planned":false,"acquired":true,"shares":11991,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"shares","element":"transactionShares","label":"F1","text":"Represents shares earned upon the vesting of performance-based restricted stock units (\"PRSUs\") for the performance period of the grant to the reporting person reported on January 18, 2023. The Compensation Committee certified achievement of the pre-established performance goal based on the Issuer's relative total shareholder return as compared to a peer group of companies at a level resulting in a vest of 167.27% of target shares. 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These shares were sold in multiple transactions at prices ranging from $75.78 to $75.94 inclusive.  The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (3) on this Form 4."}],"balance_after":66171,"source":{"system":"sec-edgar","filing":"0000874015-26-000070","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":2,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401526000070/edgardoc.xml","form_type":"4"}},{"id":936233,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2026-01-21T01:20:29.000Z","date":"2026-01-15","kind":"exercise","planned":false,"acquired":true,"shares":21473,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"kind","element":"transactionCoding","label":"F1","text":"Acquired pursuant to vesting and release of shares in accordance with Restricted Stock Unit awards."},{"field":"shares","element":"transactionShares","label":"F1","text":"Acquired pursuant to vesting and release of shares in accordance with Restricted Stock Unit awards."}],"balance_after":75362,"source":{"system":"sec-edgar","filing":"0000874015-26-000070","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":1,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401526000070/edgardoc.xml","form_type":"4"}},{"id":948712,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Non-Qualified Stock Option (right to buy)","published_at":"2026-01-06T22:35:13.000Z","date":"2026-01-02","kind":"grant","planned":false,"acquired":true,"shares":19350,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"derivative.exercise_date","element":"exerciseDate","label":"F1","text":"Grant on 01/02/2026 to reporting person of stock options under the Ionis Pharmaceuticals, Inc. 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These shares were sold in multiple transactions at prices ranging from $69.1912 to $69.32 inclusive.  The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (3) on this Form 4."}],"balance_after":53889,"source":{"system":"sec-edgar","filing":"0000874015-25-000253","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":3,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401525000253/edgardoc.xml","form_type":"4"}},{"id":1021832,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2025-10-08T22:37:00.000Z","date":"2025-10-06","kind":"sale","planned":true,"acquired":false,"shares":10200,"price":69.8872,"value":712849.44,"ownership":{"direct":true},"footnotes":[{"field":"shares","element":"transactionShares","label":"F1","text":"Shares sold pursuant to a Rule 10b5-1 Trading Plan adopted by the reporting person on May 2, 2025."},{"field":"price","element":"transactionPricePerShare","label":"F2","text":"The price reported in Column 4 is a weighted average price. 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These shares were sold in multiple transactions at prices ranging from $32.82 to $32.883 inclusive.  The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (3) on this Form 4."}],"balance_after":61203,"source":{"system":"sec-edgar","filing":"0000874015-25-000063","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":2,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401525000063/edgardoc.xml","form_type":"4"}},{"id":1300985,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2025-01-18T00:41:16.000Z","date":"2025-01-15","kind":"exercise","planned":false,"acquired":true,"shares":19690,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"kind","element":"transactionCoding","label":"F1","text":"Acquired pursuant to vesting and release of shares in accordance with Restricted Stock Unit awards."},{"field":"shares","element":"transactionShares","label":"F1","text":"Acquired pursuant to vesting and release of shares in accordance with Restricted Stock Unit awards."}],"balance_after":68563,"source":{"system":"sec-edgar","filing":"0000874015-25-000063","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":1,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401525000063/edgardoc.xml","form_type":"4"}},{"id":1312097,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Non-Qualified Stock Option (right to buy)","published_at":"2025-01-06T21:55:36.000Z","date":"2025-01-02","kind":"grant","planned":false,"acquired":true,"shares":22000,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"derivative.exercise_date","element":"exerciseDate","label":"F1","text":"Grant on 01/02/2025 to reporting person of stock options under the Ionis Pharmaceuticals, Inc. 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The\nreporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange\nCommission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (2) on this Form 4."},{"field":"balance_after","element":"sharesOwnedFollowingTransaction","label":"F1","text":"The original Form 4 filed on February 2, 2024 reported 1,961 restricted stock units sold by the reporting person which has been revised by this amendment to reflect\nthe actual amount of shares sold and beneficially owned by Mr. O'Neil."}],"balance_after":48627,"source":{"system":"sec-edgar","filing":"0000874015-24-000198","document":"primary_doc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":1,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401524000198/primary_doc.xml","form_type":"4/A","original_submission_date":"2024-02-02"}},{"id":1662917,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2024-02-03T00:55:32.000Z","date":"2024-02-02","kind":"sale","planned":false,"acquired":false,"shares":1961,"price":49.6738,"value":97410.3218,"ownership":{"direct":true},"footnotes":[{"field":"shares","element":"transactionShares","label":"F2","text":"The sale was made pursuant to an automatic sale to cover the required tax withholding obligations pursuant to the 2011 Equity Incentive Plan Performance restricted Stock Unit Agreement and Grant Notice."},{"field":"price","element":"transactionPricePerShare","label":"F3","text":"The price reported in Column 4 is a weighted average price. 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The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (3) on this Form 4."}],"balance_after":48661,"source":{"system":"sec-edgar","filing":"0000874015-24-000108","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":2,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401524000108/edgardoc.xml","form_type":"4"}},{"id":1662916,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2024-02-03T00:55:32.000Z","date":"2024-02-01","kind":"grant","planned":false,"acquired":true,"shares":3820,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"shares","element":"transactionShares","label":"F1","text":"Represents shares earned upon the vesting of performance-based restricted stock units (\"PRSUs\") for the second performance period of the grant to the reporting person reported on January 19, 2022. 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The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (2) on this Form 4."}],"balance_after":41581,"source":{"system":"sec-edgar","filing":"0000874015-23-000094","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":2,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401523000094/edgardoc.xml","form_type":"4"}},{"id":2029462,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2023-02-07T22:37:07.000Z","date":"2023-02-03","kind":"grant","acquired":true,"shares":3822,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"shares","element":"transactionShares","label":"F1","text":"Represents shares earned upon the vesting of performance-based restricted stock units (\"PRSUs\") for the first performance period of the grant to the reporting person reported on January 19, 2022. The Compensation Committee certified achievement of the pre-established performance goal based on the Issuer's relative total shareholder return as compared to a peer group of companies at a level resulting in a vest of 150% of target shares. 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These shares were sold in multiple transactions at prices ranging from $39.60 to $39.80 inclusive.  The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (3) on this Form 4."}],"balance_after":39679,"source":{"system":"sec-edgar","filing":"0000874015-23-000072","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":2,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401523000072/edgardoc.xml","form_type":"4"}},{"id":2037267,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2023-02-02T18:48:30.000Z","date":"2023-01-30","kind":"sale","acquired":false,"shares":4500,"price":39.416,"value":177372.0,"ownership":{"direct":true},"footnotes":[{"field":"shares","element":"transactionShares","label":"F1","text":"Shares sold pursuant to a Rule 10b5-1 Trading Plan adopted by the reporting person on November 16, 2022."},{"field":"price","element":"transactionPricePerShare","label":"F2","text":"The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $39.30 to $39.60 inclusive.  The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (2) on this Form 4."}],"balance_after":44179,"source":{"system":"sec-edgar","filing":"0000874015-23-000072","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":1,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401523000072/edgardoc.xml","form_type":"4"}},{"id":2051602,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Restricted Stock Unit","published_at":"2023-01-20T01:21:40.000Z","date":"2023-01-17","kind":"exercise","acquired":false,"shares":21871,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"derivative.exercise_price","element":"conversionOrExercisePrice","label":"F4","text":"Each Restricted Stock Unit represents a contingent right to receive one share of Ionis common stock, or its equivalent cash value."},{"field":"derivative.exercise_date","element":"exerciseDate","label":"F5","text":"Restricted Stock Units vest in four equal annual installments. 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The reporting person undertakes to provide to Ionis Pharmaceuticals, Inc. any security holder of Ionis Pharmaceuticals, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (3) on this Form 4."}],"balance_after":48679,"source":{"system":"sec-edgar","filing":"0000874015-23-000067","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":2,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401523000067/edgardoc.xml","form_type":"4"}},{"id":2051600,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Common Stock","published_at":"2023-01-20T01:21:40.000Z","date":"2023-01-17","kind":"exercise","acquired":true,"shares":21871,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"kind","element":"transactionCoding","label":"F1","text":"Acquired pursuant to vesting and release of shares in accordance with Restricted Stock Unit awards."},{"field":"shares","element":"transactionShares","label":"F1","text":"Acquired pursuant to vesting and release of shares in accordance with Restricted Stock Unit awards."}],"balance_after":56515,"source":{"system":"sec-edgar","filing":"0000874015-23-000067","document":"edgardoc.xml","document_sequence":1,"table":"nonDerivative","row_type":"transaction","position":1,"url":"https://www.sec.gov/Archives/edgar/data/874015/000087401523000067/edgardoc.xml","form_type":"4"}},{"id":2053180,"issuer":{"id":1182,"kind":"organization","name":"IONIS PHARMACEUTICALS INC","symbol":"IONS"},"owners":[{"id":1184,"kind":"person","name":"O'NEIL PATRICK R.","position":1,"cik":"0001564926","reported_name":"O'NEIL PATRICK R.","relationship":{"director":false,"officer":true,"ten_percent_owner":false,"other":false,"officer_title":"EVP CLO & General Counsel"}}],"security":"Restricted Stock Unit","published_at":"2023-01-19T01:19:31.000Z","date":"2023-01-15","kind":"grant","acquired":true,"shares":17207,"price":0,"value":0.0,"ownership":{"direct":true},"footnotes":[{"field":"security","element":"securityTitle","label":"F3","text":"Grant to reporting person of Restricted Stock Units under the Ionis Pharmaceuticals, Inc. 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