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Decongestants are a weird one. Pseudoephedrine is available but is behind the pharmacy counter where most people don't realize they can get it. Pretty much every other nasal decongestant has been replaced by phenylephrine which is extremely ineffective. Both the generic cold/sinus meds and sudafed PE will be most likely be phenylephrine, and you might as well not waste your money at that point. Actual pseudoephedrine (sudafed or a generic if they make it) will help.
Reminder, I am not a doctor, pharmacist, or healthcare worker. I'm just a rando on the internet who has heard a lot about this.
https://www.webmd.com/drug-medication/news/20230913/popular-otc-decongestant-ineffective
Meth heads ruined pseudoephedrine. The last thing I want to do when there's a compressor filling my sinuses with 300psi of pain is wait in the pharmacy line, show 3 forms of ID, and get questioned about why I need medicine.
Look at me. If I were to start crying from the pressure in my head, the tears would shoot forward 20ft...
That's very true and I'd argue more an issue of our regulation (or lack thereof) of both drugs and medication.