OK, the responsible medical professional in me (I'm a nurse) must tell you not to take expired medicines. In general it is not a great idea.

However, the pragmatic in me will tell you this:
There are 2 basic reasons taking expired medicine can be dangerous--(1) time can cause some ingredients to sort of evaporate so the medicine can be stronger than originally manufactured so you can't know what actual dose you are getting; (2) time can cause some active ingredients to break down so the medicine will not work or at least not work as well as it would have initially.
So basically it might be concentrated and work too much or weakened & not work at all. (In a few cases I suppose when the active ingredient breaks down it could, in theory, break down into some other kind of chemical that will have a different effect entirely than the original medicine. I reckon this is VERY unlikely in a Tylenol situation but should be considered a possiblity with other, more complicated meds.)

Confession: Not to advise you at all but just to air my own personal individual thoughts-----If I were at home with a headache or other pain and all that was available was an unopened bottle of 3 1/2 year old Tylenol, I, personally, would go ahead and take 650 mg worth (2 tabs if reg strength, a bit less than 1.5 tabs if extra strength) and see if it helped. If it is a bit stronger, it will probably still be OK because you can safely take 1000 mg of regular acetaminophen at a time. Also, one dose of acetaminophen is not likely to be dangerous even if it is a bit stronger than usual. If it is weaker, it won't work or won't work well and you will still have your pain. The fact that the bottle has been sealed all this time is comforting. That would mean moisture isn't as much of an issue.

Either way I'd try to get a new bottle as soon as convenient so you don't have to worry about what might happen.

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