Summary: Chronic idiopathic urticaria is the relatively frequent skin disease in everyday practice. In most cases of chronic urticaria we are unable to find the cause of the disease. Despite difficulties in finding the origin, in many situations we can easily treat the disease utilizing antihistamines. In this review, we focused on one of drug from this class – rupatadine. We review its pharmacokinetics and pharmacodynamics, as well as some aspects of rupatadine efficacy and safety in chronic urticaria treatment. Current guidelines are focused on quadruple dose of antihistamines in chronic urticaria treatment, when single registered dose is inefficient. Rupatadine was also tested in clinical trials utilizing the quadruple dose.