<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0206</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2024-09-29</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0000874015</issuerCik>
        <issuerName>IONIS PHARMACEUTICALS INC</issuerName>
        <issuerTradingSymbol>IONS</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0002037721</rptOwnerCik>
            <rptOwnerName>Devers Shannon L.</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>2855 GAZELLE COURT</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>CARLSBAD</rptOwnerCity>
            <rptOwnerState>CA</rptOwnerState>
            <rptOwnerZipCode>92010</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>1</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle>EVP, Chief Human Resourses Ofc</officerTitle>
        </reportingOwnerRelationship>
    </reportingOwner>

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        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>7909</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <derivativeTable>
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            <securityTitle>
                <value>Non-Qualified Stock Option (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>32.6</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2023-01-03</value>
            </exerciseDate>
            <expirationDate>
                <value>2032-01-02</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>14368</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
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            </securityTitle>
            <conversionOrExercisePrice>
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            <exerciseDate>
                <value>2024-01-03</value>
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            <expirationDate>
                <value>2033-01-02</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>15317</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
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        <derivativeHolding>
            <securityTitle>
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            </securityTitle>
            <conversionOrExercisePrice>
                <value>48.51</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2021-04-05</value>
            </exerciseDate>
            <expirationDate>
                <value>2027-04-04</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>6000</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Non-Qualified Stock Option (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
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            <exerciseDate>
                <value>2019-01-02</value>
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            <expirationDate>
                <value>2025-01-01</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
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                    <value>16042</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
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        <derivativeHolding>
            <securityTitle>
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                <underlyingSecurityTitle>
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                <underlyingSecurityShares>
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        <derivativeHolding>
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                <value>Non-Qualified Stock Option (right to buy)</value>
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            <exerciseDate>
                <value>2020-01-02</value>
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            <expirationDate>
                <value>2026-01-01</value>
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            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
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                </underlyingSecurityShares>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
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        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Non-Qualified Stock Option (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
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            </conversionOrExercisePrice>
            <exerciseDate>
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            <expirationDate>
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            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
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                <underlyingSecurityShares>
                    <value>28516</value>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
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        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Non-Qualified Stock Option (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>60.89</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <value>2021-01-02</value>
            </exerciseDate>
            <expirationDate>
                <value>2027-01-01</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>17125</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Restricted Stock Unit</value>
                <footnoteId id="F1"/>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.0</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F2"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F2"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>31241</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">Each restricted stock unit represents a contingent right to receive one share of Ionis common stock, or its equivalent cash value.</footnote>
        <footnote id="F2">Grants to reporting person of restricted stock units under the Ionis Pharmaceuticals, Inc. Amended and Restated 2011 Equity Incentive Plan on January 15, 2021, January 15, 2022, January 15, 2023 and January 15, 2024. The restricted stock units vest in four equal annual installments.  Upon vesting, the restricted stock units will be paid out in whole shares of Ionis common stock or cash as may be determined by the Company.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>By: Patrick R. O'Neil, attorney-in-fact For: Shannon L. Devers</signatureName>
        <signatureDate>2024-10-01</signatureDate>
    </ownerSignature>
</ownershipDocument>
