Chronic spontaneous urticaria is characterized by reccurent wheals lasting more than 6 weeks, it can persist for months or years. The disease can lead to a significant worsening in the quality of life. According to recent guidelines second-generation non-sedative antihistamines are the first-line treatment. If the therapeutic effect of the standard dose of antihistamines is insufficient, it is recommended to up-dose to 4-fold.