Q: Onset of action of diazepam Q: Quick answer A: Diazepam onset depends on route: - IV: about 1-3 minutes - Rectal: about 5-10 minutes - Oral: usually 15-60 minutes peak clinical effect may take 1-2 hours - IM: absorption is variable and generally not preferred for urgent effect For acute seizures or severe agitation, IV diazepam acts very rapidly but requires monitoring because of risk of respiratory depression.