In a patient taking warfarin and verapamil, what is the primary concern when introducing alendronic acid, considering the potential interactions and the patient's condition?
Decreased efficacy of alendronic acid due to competition for CYP3A4 by warfarin Potential for reduced pain relief from acetaminophen due to interactions with alendronic acid Increased risk of hypotension due to additive effects of alendronic acid and verapamil Potential for increased bleeding risk due to CYP3A4 inhibition by verapamil affecting warfarin metabolism