Took breztri aerosphere for 1st time. got terrible back ache that felt like my lower back ache, but higher up on my back-under rib cage. the ache travel up my back (bottom to top of rib cage). may this be paradoxical bronchosasm an adverse reaction?

It is more likely that you have muscular strain. Some pulmonary conditions such as a collapsed lung may present in this manner. If you have any shortness of breath or persistent pain, please see urgent care or the Emergency room. Discuss the use of a heating pad and NSAID with your physician. Rinse mouth after use of inhalers and discuss a vitamin D level with your PCP.